Rheumatic Heart Disease Symptoms And What You Need To Know

Rheumatic heart disease is a long-term complication that develops after episodes of acute rheumatic fever. This condition typically occurs when the initial infection, often linked to untreated strep throat, leads to inflammation that affects the heart. Over time, repeated inflammation and turbulent blood flow can cause damage to the heart valves, especially the mitral valve.

Understanding The Root Cause

When rheumatic fever affects the heart, it triggers a cascade of physiological changes. Platelets and fibrin begin to accumulate due to chronic inflammation, leading to structural changes in the heart valves. The mitral valve becomes thickened, rough, and may stick together. In addition, the chordae tendineae—fibrous cords that anchor the valve—can shorten, fuse, or even calcify, impairing the valve's ability to function properly.

Common Symptoms Of Rheumatic Heart Disease

One of the most noticeable symptoms is exertional dyspnea—difficulty breathing during physical activity, while breathing remains normal at rest. As the disease progresses, individuals may also experience paroxysmal nocturnal dyspnea, a condition where they wake up suddenly gasping for air. Another telltale sign is orthopnea, or shortness of breath when lying flat, which often forces patients to sleep sitting upright.

Additional Physical Manifestations

Beyond respiratory issues, people with rheumatic heart disease may suffer from hemoptysis, or coughing up blood, due to pressure buildup in the lungs. Gastrointestinal symptoms like poor appetite, nausea, and vomiting are also common, as are reduced urine output and swelling in the lower extremities. Fatigue is another key symptom, often accompanied by generalized weakness and fluid retention leading to edema.

Why These Symptoms Occur

These clinical signs are largely a result of left-sided heart failure caused by long-standing pulmonary hypertension. As pressure increases in the pulmonary circulation, blood begins to back up into the left atrium and ventricle, eventually impairing the heart's ability to pump efficiently. This cascade leads to congestion in the lungs and systemic symptoms that significantly impact quality of life.

What You Should Do

If you or someone you know is experiencing these symptoms, especially after a history of rheumatic fever, it's crucial to seek medical attention. Early diagnosis and treatment can help slow disease progression and improve long-term outcomes. Managing risk factors, such as timely antibiotic treatment for streptococcal infections, can also prevent the onset of rheumatic heart disease.