Rheumatic Heart Disease: Understanding Its Causes and Impact

Rheumatic heart disease (RHD) is a long-term condition that primarily affects the heart valves, resulting from repeated episodes of rheumatic fever. This condition often follows an untreated or improperly treated infection caused by group A Streptococcus bacteria, which is commonly responsible for strep throat and, less frequently, skin infections like scarlet fever.

The Link Between Streptococcus and Rheumatic Heart Disease

When the body is exposed to a streptococcal infection, the immune system responds by producing antibodies to fight off the bacteria. In some cases, especially when the infection is left untreated, these antibodies mistakenly attack the body's own tissues—particularly those found in the joints, skin, brain, and most importantly, the heart. This autoimmune reaction leads to inflammation and scarring, especially in the heart valves, which can cause long-term damage.

Which Heart Valves Are Most Affected?

While rheumatic heart disease can impact any of the four heart valves, the mitral valve is most commonly affected. This is followed by the aortic valve, which may also suffer from inflammation and scarring. Over time, this damage can result in valve stenosis (narrowing of the valve opening) or regurgitation (leakage of blood back through the valve), both of which disrupt normal blood flow through the heart.

Consequences of Valve Damage

As the heart valves become damaged, they are unable to open or close properly, which can lead to a range of cardiovascular complications. These include increased pressure within the heart chambers, reduced efficiency of blood circulation, and potential heart failure if the condition progresses without treatment. Patients may experience symptoms such as fatigue, shortness of breath, swelling in the legs, and irregular heartbeats.

Treatment Options for Severe Rheumatic Heart Disease

In mild cases, patients may not require immediate intervention but should be monitored regularly. However, in more advanced stages, surgical treatment may be necessary. This often involves valve repair or, more commonly, valve replacement surgery. The goal of such procedures is to restore normal heart function and improve the patient's quality of life.

Prevention remains a key strategy in reducing the incidence of rheumatic heart disease. Prompt diagnosis and complete treatment of streptococcal infections with antibiotics can significantly lower the risk of developing this serious condition.