Rheumatic heart disease causes symptoms and prevention methods

Rheumatic Heart Disease: Everything You Need to Know

Rheumatic heart disease can start with something as simple as a sore throat. But if left untreated, it can lead to serious heart valve problems. This condition mainly affects children and teenagers and needs continuous follow-up and treatment to avoid complications.

In this article from Daleely Medical, we'll walk you through:

✔️ What is rheumatic heart disease?
✔️ Symptoms in both adults and children
✔️ Treatment options, including medication and surgery
✔️ And—can it be prevented?

Stay with us for a simple, comprehensive guide to help protect yourself or your child from rheumatic heart disease and its complications.

What Is Rheumatic Heart Disease?

Rheumatic heart disease is permanent damage to the heart valves that occurs after a person has had rheumatic fever—a condition that develops when strep throat (caused by Group A Streptococcus bacteria) isn’t treated properly.

It usually affects children and teenagers between the ages of 5 and 15, especially in places where access to healthcare is limited or delayed.

1. Does rheumatic heart disease only affect adults?
Nope! It usually starts in childhood after untreated strep throat, but symptoms can appear years later—even in adulthood.

2. Is rheumatic heart disease contagious?
The disease itself isn’t contagious. But the bacteria that cause strep throat can spread from person to person.

3. Is there a permanent cure for rheumatic heart disease?
There’s no full cure, but medications and surgery can help you manage the condition and live a normal life while protecting your heart from getting worse.

4. What’s the difference between rheumatic fever and rheumatic heart disease?

Rheumatic fever happens after a throat infection that wasn’t treated properly.
Rheumatic heart disease is what happens after the fever damages the heart valves.

5. Do I have to take penicillin injections for life?
In some cases—yes.
The duration depends on the condition of the heart and the patient’s age. It could be 5 years or longer, based on your doctor’s decision.

6. Can rheumatic heart disease prevent marriage or pregnancy?
No, not necessarily.
But you need regular follow-ups with a cardiologist, especially during pregnancy, to make sure everything stays under control.

7. Can a child fully recover?
Yes! If the condition is diagnosed early and treated properly, the child can live a completely normal life without heart problems.

8. Can I play sports if I have rheumatic heart disease?
Yes—but only after consulting your doctor.
Some people can do light exercise, depending on their heart’s condition.

9. When should I see a doctor?
If you notice any of the following:

Heart palpitations or fast heartbeats
Shortness of breath
Fatigue from minimal effort
Swelling in the legs
High fever returning after a sore throat

❗ Don’t delay—see a cardiologist or rheumatologist immediately.

❓ What Causes Rheumatic Heart Disease? Who’s Most at Risk?

Rheumatic heart disease doesn’t appear out of nowhere. It often starts with a simple sore throat. If left untreated, it can lead to inflammation in the heart valves and cause permanent damage.

✅ Main causes of rheumatic heart disease:

1. Strep throat (caused by Streptococcus bacteria)
This is the main cause. It happens when the throat infection isn’t treated properly. The immune system then mistakenly attacks the heart instead of just fighting the bacteria!

2. Overactive immune response
Some children have an overly aggressive immune response to this bacteria, causing the body to attack joints and the heart.

3. Repeated untreated throat infections
If throat infections happen frequently without proper treatment, rheumatic fever may return again and again—each time damaging the heart more.

4. Delayed or ignored treatment
The longer you wait to treat a sore throat, the higher the risk of heart complications.

Who’s Most at Risk of Rheumatic Heart Disease?

Children and teens between 5 and 15 years old
People living in overcrowded areas or with poor access to healthcare
Those with a family history of rheumatic fever
Anyone who doesn’t finish their antibiotic course after a sore throat

⏳ How Does Rheumatic Fever Turn Into Rheumatic Heart Disease?

When rheumatic fever happens repeatedly, it can lead to heart valve inflammation, which causes:

Narrowing or damage to the mitral valve (the most common)
Blood leakage through a valve that no longer closes properly
Weakened heart pumping

This can result in:

Heart failure
Blood clots
Atrial fibrillation

How Is Rheumatic Heart Disease Diagnosed?

✅ 1. Medical history & physical exam
Your doctor will ask about symptoms like:

Palpitations
Chest pain
Shortness of breath
Swollen legs

They’ll also listen to your heart for a murmur (an abnormal sound that can suggest valve problems).

✅ 2. Echocardiogram (ECHO)
This is the most important test. It shows:

The condition of your heart valves
Any narrowing or leakage
The level of inflammation affecting the heart muscle

Sometimes it’s done through the esophagus if the image is unclear.

✅ 3. ECG (Electrocardiogram)
This checks for heart rhythm issues or heart muscle enlargement.

✅ 4. Blood tests
These detect active inflammation, including:

ESR (Erythrocyte Sedimentation Rate)
CRP (C-Reactive Protein)
ASO Titer (indicates past strep infection)

✅ 5. Chest X-ray
Used to see if the heart is enlarged or if the lungs show signs of fluid retention.

✅ 6. Cardiac catheterization (advanced cases)
Performed if more detailed imaging is needed before surgery or if the diagnosis is unclear.

⚠️ Dangers of Rheumatic Heart Disease – When Is Chest Pain Serious?

Rheumatic heart disease isn’t just about valve damage. If untreated, it can lead to serious complications. Many people ask:

Can it lead to heart failure? Is chest pain (or heart “stabbing”) something to worry about?

Here’s what you should know

Effects of Rheumatic Disease on the Heart:

1. Valve damage
Heart valves may:

Narrow and not open fully
Leak and not close properly

This affects the heart’s ability to pump blood, causing fatigue and breathlessness.

2. Heart attack
May occur due to:

Weak valves
Narrow arteries
This reduces blood flow to the heart, leading to chest pain.

3. Endocarditis (inflammation of the inner lining of the heart)
Caused by a bacterial infection entering the bloodstream—especially dangerous if valve damage already exists.

4. Valve rupture
A rare but severe complication in advanced stages that needs immediate surgery.

5. Heart failure
The heart can no longer pump blood efficiently, causing:

Leg swelling
Severe breathlessness
Extreme fatigue

⚠️ Can Rheumatic Heart Disease Be Fatal?

Yes, if serious complications develop—like:

Heart failure
Valve rupture

But here’s the good news:
If diagnosed early and managed well, you can avoid all of that. With treatment and commitment, you can protect your heart for years to come.

What Is Rheumatic Heart Disease?

Rheumatic heart disease is a long-term damage to the heart valves caused by rheumatic fever — a complication of untreated strep throat (caused by group A Streptococcus bacteria).

It’s most common among children aged 5–15, especially in crowded or low-resource settings where access to healthcare is limited.

❓ FAQs About Rheumatic Heart Disease (In Simple Terms)

1. Can adults get it too?
Yes. It often starts in childhood, but symptoms might not appear until adulthood.

2. Is it contagious?
The heart disease itself isn’t contagious, but the strep throat infection that causes it can spread.

3. Is there a permanent cure?
There’s no permanent cure, but medication and surgery can help you live a normal life and prevent further heart damage.

4. What’s the difference between rheumatic fever and rheumatic heart disease?

Rheumatic fever: Happens after untreated strep throat.
Rheumatic heart disease: Happens when rheumatic fever damages the heart valves.

5. Do I need to take penicillin shots for life?
In some cases, yes. It depends on your age and how much your heart is affected. Some people need them for 5+ years.

6. Can I still get married or pregnant?
Yes! But you need regular check-ups, especially during pregnancy. Many women have healthy pregnancies with proper care.

7. Can a child fully recover?
Yes, if diagnosed early and treated well. They can live a normal, healthy life.

8. Can I exercise?
Yes — but it depends on your condition. Ask your doctor before doing any activity.

9. When should I see a doctor?
If you feel any of these:

Rapid heartbeat
Shortness of breath
Fatigue with light activity
Swollen feet or legs
Repeated fever after sore throats

See a heart or rheumatology doctor ASAP.

What Causes Rheumatic Heart Disease? And Who’s at Risk?

Rheumatic heart disease usually starts from untreated strep throat. If left unmanaged, the immune system may attack the heart valves by mistake.

Main causes:

Strep throat (Group A Streptococcus)
If not treated properly, your immune system might confuse heart tissue with bacteria and attack both.
Overactive immune response
Especially in children — their bodies might react strongly and harm joints and the heart.
Repeated untreated infections
Recurring sore throats increase the risk of rheumatic fever and long-term heart damage.
Delayed or incomplete treatment
The longer you wait to treat an infection, the higher the risk of complications.

Who is most at risk?

Children aged 5–15
People in crowded or low-healthcare areas
Those with a family history of rheumatic fever
Anyone who doesn't finish their full course of antibiotics

When Does Rheumatic Fever Affect the Heart?

It often takes 10–20 years for valve damage to appear — but in some cases, it can happen faster.

❤️ Heart-related symptoms:

Extreme fatigue
Difficulty breathing (especially when lying down)
Chest pain or pressure
Irregular heartbeats
Swollen feet/ankles
Dizziness or fainting

If you feel more than one symptom — don’t wait. See a cardiologist.

Treatment for Rheumatic Heart Disease

1. Antibiotics (like penicillin)

Prevent repeat infections
Long-term use (often years)

2. Anti-inflammatories

Aspirin, naproxen – reduce swelling and pain

3. Corticosteroids

Like Prednisolone, in severe cases (must be prescribed)

4. Heart medications

Diuretics to reduce fluid
Beta-blockers like Concor
ACE inhibitors to support heart function

When Is Surgery Needed?

When medication isn’t enough, and heart valves are too damaged.

⚠️ Surgery may be required if:

Severe valve narrowing or leaking
Weak or enlarged heart muscle
Dangerous symptoms like extreme breathlessness, swelling, or fainting
No improvement with medication

Types of surgeries:

Valve replacement
- Mechanical valve: Long-lasting but needs blood thinners for life
- Tissue valve: Doesn’t need blood thinners, but may need replacement in future
Valve repair
- Preferred in children and young people — avoids lifelong medications
Open-heart surgery or catheter procedures
- Depends on the case; some use a catheter through the leg for less invasive valve replacement

Life After Heart Surgery

Post-surgery, you’ll need:

Blood thinners (if using mechanical valves)
Regular antibiotics to prevent infections
Routine follow-ups
Healthy lifestyle (low salt, low fat, moderate exercise, no smoking)

⚠️ Possible risks (rare):

Bleeding
Infection
Clots
Valve failure

Can You Prevent Rheumatic Heart Disease?

Yes – with awareness and early treatment.

How it starts:

Untreated strep throat → Rheumatic fever → Heart valve damage

✅ Prevention tips:

Treat sore throats early
- High fever, white patches on tonsils = see a doctor and get tested
Finish the full antibiotic course
- Even if symptoms disappear — usually 10 full days
Secondary prevention (if you had rheumatic fever before)
- Regular penicillin shots every 3–4 weeks to avoid relapse
Watch for warning signs
- Joint pain, recurring fever, or fatigue = see a doctor

Living With Rheumatic Heart Disease

If you or your child has been diagnosed — don’t panic. You can live a healthy, active life with the right care.

What does “living with it” mean?

It means being aware of your condition, following treatment, and protecting your heart every day.

Steps to live well:

Stick to penicillin injections
- Never miss them — they’re your shield
See your cardiologist regularly
- Get ECG and Echo tests to check heart function
Monitor your symptoms
- Report any new issues right away
Take all prescribed meds — no skipping
- Don’t stop without your doctor’s advice
Live a heart-friendly lifestyle
- Eat healthy, move more, stay stress-free, avoid smoking
Before any surgery or dental work
- Tell your doctor — you might need preventive antibiotics
Mental and emotional support
- Talk to someone you trust, explain the condition to kids in simple words, and join support groups if needed