Rheumatic Heart Disease Causes and Risk Factors

Rheumatic heart disease (RHD) is a long-term complication that can develop after a bacterial infection, particularly one caused by group A Streptococcus. This condition primarily affects the heart valves and is often the result of untreated or under-treated rheumatic fever, which typically occurs in children and young adults under the age of 20.

Environmental Influences on RHD Development

One of the contributing factors to the onset of rheumatic heart disease is prolonged exposure to damp or humid living conditions. These environments can promote bacterial growth and weaken the immune system, increasing the likelihood of streptococcal infections. In the past, especially before the 1980s, people living in remote and underdeveloped regions were at a higher risk due to poor sanitation and limited access to medical care.

The Role of Bacterial Infections

The primary trigger for rheumatic fever—and subsequently rheumatic heart disease—is a bacterial infection, most commonly strep throat. When these infections are not properly treated with antibiotics, the body's immune system may mistakenly attack its own tissues, including the heart valves. This autoimmune response can lead to inflammation and long-term damage, such as valve thickening, scarring, or leakage.

Historical Trends and Medical Advancements

In earlier decades, the prevalence of rheumatic heart disease was significantly higher due to inadequate healthcare infrastructure. Many patients developed serious complications like valve stenosis or regurgitation because infections were often left untreated. However, with improvements in public health, better hygiene practices, and early medical interventions, the incidence of RHD has dramatically decreased in many parts of the world.

Modern Prevention and Treatment

Today, early detection and prompt antibiotic treatment of sore throats and joint pain have become key strategies in preventing rheumatic fever and its progression to heart disease. As a result, the number of new cases has declined significantly, especially in regions with accessible healthcare systems. Public awareness and timely medical care continue to play a vital role in reducing the global burden of rheumatic heart disease.