Rheumatic Heart Disease: Which Parts of the Heart Does It Affect?

Rheumatic heart disease (RHD) is a long-term condition that primarily affects the heart valves due to damage caused by rheumatic fever. This disease most commonly impacts the mitral valve, followed by the aortic valve, and less frequently the tricuspid and pulmonary valves. The damage to these valves can lead to various complications, including valve stenosis or regurgitation, which ultimately affect the heart's ability to function properly.

Impact on the Mitral Valve

One of the primary valves affected by rheumatic heart disease is the mitral valve, located between the left atrium and left ventricle. When damaged, the mitral valve may become stiff or leaky, resulting in mitral stenosis or mitral regurgitation. In the early stages of the disease, patients may not experience any noticeable symptoms. However, as the condition progresses, symptoms such as shortness of breath, fatigue, coughing, and even hemoptysis (coughing up blood) may occur due to pulmonary congestion or heart failure.

Effects on the Aortic Valve

The aortic valve is the second most commonly affected valve in rheumatic heart disease. Damage to this valve can lead to aortic regurgitation or aortic stenosis, both of which impair the heart's ability to pump blood efficiently. Patients may experience chest pain (angina), dizziness, fainting spells (syncope), and in severe cases, sudden cardiac death. These symptoms often arise due to reduced blood flow to the coronary arteries or increased strain on the heart muscle.

Treatment Options for Rheumatic Heart Disease

In the early stages of rheumatic heart disease, management focuses on preventing further damage and preserving heart function. This includes avoiding activities that place extra strain on the heart and taking antibiotics to prevent recurrent streptococcal infections. As the disease progresses and heart failure develops, treatment may involve medications such as diuretics, vasodilators, and inotropic agents to improve cardiac output and relieve symptoms.

When Surgery Becomes Necessary

When valve damage becomes severe, surgical intervention may be required. Procedures such as valve repair (valvuloplasty) or valve replacement are commonly performed to restore normal blood flow through the heart. Additionally, many patients with rheumatic heart disease develop atrial fibrillation, which increases the risk of blood clots. In such cases, anticoagulant therapy is typically prescribed to reduce the risk of stroke.

Seeking Specialized Care

Managing rheumatic heart disease requires a comprehensive and individualized approach. Patients are strongly encouraged to seek care at specialized cardiovascular centers where they can receive timely diagnosis, ongoing monitoring, and appropriate treatment. With proper medical and surgical interventions, individuals affected by this condition can lead healthier and more fulfilling lives.