Rheumatic Heart Disease: Understanding Its Causes and Development

Rheumatic heart disease primarily affects children and young adults. It often begins when individuals are exposed to cold and damp environments for extended periods or experience frequent upper respiratory infections such as pharyngitis or tonsillitis. These conditions create a favorable environment for the accumulation of group A Streptococcus bacteria in the throat and respiratory tract, increasing the risk of bacterial invasion into the body.

How Streptococcus Infection Leads to Heart Damage

Once group A Streptococcus enters the bloodstream, it can travel to the heart and trigger an abnormal immune response. This reaction leads to acute non-suppurative inflammation, affecting various parts of the heart including the myocardium, endocardium, and valve annulus. The immune system's attack on the bacteria mistakenly damages heart tissues, particularly causing structural changes in heart valves such as thickening and adhesion, which impair normal valve function.

Early Signs and Symptoms

In clinical settings, valve dysfunction is a common manifestation of rheumatic heart disease. During the early stages, patients may develop a distinctive heart murmur different from typical mitral regurgitation. This murmur is characterized by a unique rumbling sound during heart diastole – the phase when the heart relaxes and fills with blood. This specific auscultatory finding helps physicians identify potential valve involvement.

Progression to Heart Failure

As the disease progresses, affected individuals may begin experiencing symptoms of heart failure. These can include shortness of breath, particularly during physical exertion or when lying flat, and persistent feelings of chest tightness. These symptoms arise from the heart's decreasing ability to pump blood efficiently due to valve damage and subsequent cardiac strain. Early recognition of these warning signs is crucial for timely medical intervention and management.