Rheumatic Heart Disease: A Comprehensive Guide
Rheumatic heart disease (RHD) refers to heart damage caused by rheumatic fever, which often affects the heart valves. In the early stages, symptoms may not be obvious, but valve damage can lead to characteristic heart murmurs and changes in the size of the heart chambers. As the condition progresses, patients may experience symptoms such as dizziness, fatigue, palpitations, shortness of breath, coughing, and even hemoptysis. These are signs of left-sided heart failure. On the other hand, right-sided heart failure can manifest as jugular vein distension, abdominal bloating, swelling, nausea, and leg edema.
Key Characteristics of Rheumatic Heart Disease
One of the most typical presentations of rheumatic heart disease is mitral valve involvement, particularly mitral stenosis. This condition produces a low-pitched, rumbling diastolic murmur best heard at the apex of the heart. This unique heart sound is a hallmark of the disease and helps in its clinical identification.
Causes and Underlying Mechanisms
Rheumatic heart disease is primarily triggered by an abnormal immune response following infection with Group A beta-hemolytic streptococcus bacteria. This reaction leads to inflammation and damage to the heart tissues, making it a form of autoimmune disorder. The body's immune system mistakenly attacks its own heart tissues, particularly the valves, causing long-term damage.
Diagnosis of Rheumatic Heart Disease
Diagnosing rheumatic heart disease involves a combination of clinical evaluation, physical examination, and diagnostic tests. Commonly used imaging techniques include echocardiography, chest X-rays, electrocardiograms (ECG), and in some cases, coronary angiography. These tools help doctors assess the structure and function of the heart and its valves.
Treatment Options for Rheumatic Heart Disease
The management of rheumatic heart disease can be categorized into three main approaches: general care, medication, and surgical intervention. Medications such as diuretics, vasodilators, and digitalis preparations are often prescribed to manage symptoms and improve heart function. For more advanced cases, surgical procedures like valve replacement or balloon valvuloplasty may be necessary to restore normal blood flow through the heart.
Lifestyle and Preventive Measures
In daily life, patients should avoid heavy physical exertion and intense exercise. Regular follow-ups with a cardiologist are essential to monitor the condition. A healthy diet consisting of light, easily digestible meals is also recommended to support overall heart health and prevent complications.