Rheumatic Heart Disease Symptoms in Advanced Stages

Rheumatic heart disease (RHD) is a long-term complication resulting from untreated or under-treated streptococcal infections, primarily affecting the heart valves. In the advanced or end-stage of this condition, patients often experience severe valve dysfunction, including significant regurgitation or stenosis. These valve impairments can drastically impact heart function and overall health.

Key Symptoms of End-Stage Rheumatic Heart Disease

Impact on Mitral Valve

When the disease affects the mitral valve, it can lead to severe mitral stenosis or regurgitation. These conditions impair the heart's ability to pump blood efficiently, leading to symptoms such as shortness of breath, especially during physical exertion or when lying flat. Patients may also experience a reduced capacity for physical activity, persistent coughing, and even hemoptysis (coughing up blood).

Common Cardiovascular Symptoms

As the condition progresses, individuals may develop chest pain or discomfort due to the heart's increased workload. This is often accompanied by fatigue and weakness, which can significantly affect quality of life.

Signs of Heart Failure

Advanced rheumatic heart disease frequently leads to congestive heart failure. This manifests through symptoms such as jugular venous distention (visible swelling of neck veins), peripheral edema (particularly in the lower extremities), loss of appetite, abdominal bloating, and generalized weakness. These signs indicate the heart's inability to circulate blood effectively.

Associated Complications

Risk of Arrhythmias

Patients in the late stages of RHD are at increased risk of developing various arrhythmias. Common types include atrial fibrillation, frequent premature ventricular contractions, and short episodes of ventricular tachycardia. These irregular heartbeats can further compromise cardiac output and increase the risk of complications.

Potential for Thromboembolism and Sudden Death

One of the most dangerous complications of advanced rheumatic heart disease is the risk of thromboembolism, especially in patients with atrial fibrillation. Blood clots formed in the heart can travel to vital organs, causing strokes or other life-threatening events. Additionally, severe arrhythmias may lead to sudden cardiac death, emphasizing the importance of timely medical intervention and monitoring.