Treatment Options for Rheumatic Heart Disease

Rheumatic heart disease is a long-term complication of untreated or undertreated rheumatic fever, often affecting the heart valves. Timely and appropriate treatment is crucial to prevent further damage and improve quality of life. Below are the key treatment strategies for managing rheumatic heart disease.

1. Controlling Rheumatic Activity

The first and most fundamental step in treatment is to control the underlying rheumatic activity. This typically involves the use of anti-inflammatory medications such as aspirin or corticosteroids to reduce inflammation and prevent further damage to the heart. In many cases, antibiotics like penicillin are prescribed to eliminate any remaining group A streptococcus bacteria, which are the root cause of rheumatic fever.

2. Minimally Invasive Procedures for Valve Stenosis

When Surgery Isn't Immediately Necessary

If the disease primarily affects the heart valves by causing stenosis (narrowing), such as in mitral stenosis or aortic stenosis without significant regurgitation, a minimally invasive procedure called balloon valvuloplasty may be recommended. This procedure involves inserting a catheter with a balloon into the affected valve and gently expanding it to improve blood flow without the need for open-heart surgery.

3. Open-Heart Surgery for Severe Valve Damage

Addressing Valve Regurgitation

In cases where valve damage has progressed to severe regurgitation (leakage), surgical intervention becomes necessary. This typically involves open-heart surgery to replace the damaged valve with either a mechanical or biological prosthetic valve. Valve replacement can significantly improve heart function and reduce symptoms, helping patients regain a better quality of life.

4. Managing Heart Rhythm Complications

Handling Atrial Fibrillation and Blood Clots

Patients with rheumatic heart disease are at increased risk of developing arrhythmias such as atrial fibrillation. When this occurs, blood can pool in the left atrium or left atrial appendage, increasing the risk of clot formation. Depending on the individual case, treatment may include blood thinners (anticoagulants) or other rhythm-regulating medications. In some cases, procedures like cardioversion or catheter ablation may be considered to restore normal heart rhythm and reduce stroke risk.