Rheumatic Heart Disease Versus Congenital Heart Disease: Understanding the Key Differences

Rheumatic heart disease and congenital heart disease are two distinct types of heart conditions that differ significantly in their causes, development, and impact on the body. The primary distinction lies in when the condition develops. Congenital heart disease is present at birth and is typically the result of abnormal heart development during fetal growth. On the other hand, rheumatic heart disease is not present at birth but develops later in life as a result of damage to the heart valves caused by rheumatic fever, a complication of untreated streptococcal infections.

Causes and Development

Congenital heart disease arises during pregnancy when the heart does not form correctly. Genetic factors, maternal infections, or exposure to certain medications or chemicals can contribute to these structural abnormalities. These defects often involve the walls of the heart, blood vessels, or valves, and may include issues such as septal defects or abnormal blood vessel connections.

Rheumatic heart disease, by contrast, is a preventable and acquired condition that typically follows an episode of rheumatic fever. This inflammatory disease can occur after a strep throat infection is left untreated or improperly managed. Over time, repeated episodes of rheumatic fever can lead to permanent damage to the heart valves, particularly the mitral and aortic valves.

Type of Heart Involvement

Congenital Heart Conditions

Most congenital heart defects involve structural problems such as holes in the heart walls (atrial or ventricular septal defects), abnormal connections between blood vessels, or malformations of the heart chambers. While some congenital conditions do affect the heart valves—such as congenital mitral valve stenosis or pulmonary valve stenosis—the majority of cases are not primarily valve-related.

Rheumatic Heart Conditions

Rheumatic heart disease almost exclusively affects the heart valves. The inflammation caused by rheumatic fever leads to scarring and thickening of the valve tissue, which can result in stenosis (narrowing of the valve) or regurgitation (leakage of blood backward through the valve). These valve impairments can significantly impact heart function and may require surgical intervention over time.

Prevention and Management

Preventing congenital heart disease involves prenatal care, avoiding harmful substances during pregnancy, and genetic counseling when necessary. In contrast, rheumatic heart disease can often be prevented with prompt diagnosis and treatment of streptococcal infections using antibiotics. Long-term management for both conditions may involve regular medical follow-ups, medications, and in some cases, surgical correction or valve replacement.