Rheumatic Heart Disease Symptoms and Signs

Rheumatic heart disease (RHD) primarily results from an abnormal immune response triggered by infection with group A beta-hemolytic streptococcus bacteria. This condition often follows untreated or inadequately treated strep throat infections, leading to inflammation and damage to the heart valves and other cardiac structures.

Common Symptoms of Rheumatic Heart Disease

Patients suffering from rheumatic heart disease typically experience a variety of symptoms, which may worsen as the disease progresses. These include palpitations, shortness of breath, fatigue, persistent coughing, swelling in the extremities, and the presence of pink, frothy sputum. These symptoms are often related to heart failure and fluid buildup in the lungs due to impaired cardiac function.

Typical Physical Signs of RHD

Cardiac Indicators

One of the most notable signs of rheumatic heart disease is an enlarged heart, which can be detected through imaging techniques such as chest X-rays or echocardiograms. Other cardiac signs include tachycardia (rapid heart rate) and a weakened first heart sound at the apex, which is typically heard during a physical examination using a stethoscope.

Pulmonary and Pericardial Involvement

In many cases, patients may exhibit signs of pulmonary congestion, particularly at the lung bases. Additionally, pericardial involvement may occur, leading to symptoms such as chest pain and further complicating the clinical picture of the disease.

Musculoskeletal and Dermatological Manifestations

Joint involvement is also common, with signs such as redness, swelling, and pain in the joints, often accompanied by limited range of motion. In a smaller subset of patients, a distinctive skin manifestation known as erythema marginatum may appear. This rash presents as large, red, ring-shaped lesions with a pale center, typically found on the trunk and inner surfaces of the limbs.