Rheumatic Heart Disease Diagnosis Criteria

Rheumatic heart disease, more precisely referred to as rheumatic heart valve disease in clinical terms, develops as a consequence of acute rheumatic fever. Even after the initial infection is resolved, some patients experience long-term complications affecting the heart valves. These complications may include valve thickening, which can progressively lead to calcification, hardening, and ultimately impaired valve function. The most common types of valve dysfunction are stenosis (narrowing of the valve) and regurgitation (leakage due to improper closure), and in some cases, both conditions may coexist.

Key Diagnostic Indicators

1. History of Rheumatic Fever: A confirmed or suspected prior episode of rheumatic fever is a crucial factor in diagnosing rheumatic heart disease. This condition is a post-streptococcal autoimmune response, often occurring weeks or months after an untreated strep infection.

2. Laboratory Findings

Elevated Inflammatory Markers: As an autoimmune and inflammatory condition, rheumatic heart disease can present with increased erythrocyte sedimentation rate (ESR) and elevated levels of antistreptolysin O (ASO) titers. These findings support the diagnosis and reflect recent streptococcal activity.

3. Imaging and Diagnostic Tests

Echocardiography: This is the primary imaging tool used to evaluate heart valve structure and function. It can detect abnormalities such as thickening, calcification, stenosis, or regurgitation of the valves.

Chest X-ray: May show signs of heart enlargement or pulmonary congestion, especially in advanced cases.

Electrocardiogram (ECG): Helps identify arrhythmias or signs of chamber enlargement, which are often associated with valvular dysfunction.

When combined, these clinical, laboratory, and imaging findings provide a comprehensive basis for diagnosing rheumatic heart disease. Early detection and ongoing monitoring are essential for managing the condition and preventing serious complications such as heart failure, stroke, or infective endocarditis.