Rheumatic Heart Disease: Understanding Its Causes and Impact

Rheumatic heart disease (RHD) is a long-term condition that develops as a result of repeated episodes of rheumatic fever, which gradually damage the heart valves. It is considered one of the major complications of rheumatic fever, a systemic inflammatory disease that primarily affects the heart, joints, skin, and brain.

What Causes Rheumatic Fever?

The primary cause of rheumatic fever is an untreated or inadequately treated infection of the upper respiratory tract caused by Group A beta-hemolytic streptococcus bacteria. This bacterial infection, commonly known as strep throat, can trigger an abnormal autoimmune response in some individuals, leading to widespread inflammation throughout the body, including the heart.

Other Contributing Factors

In addition to bacterial infection, several other factors may contribute to the development of rheumatic fever. These include viral infections, genetic predisposition, and dysfunctions in the immune system. Researchers believe that a combination of environmental and biological factors increases the likelihood of developing the condition.

Who Is Most at Risk?

Rheumatic fever most commonly affects children between the ages of 9 and 17, with a higher incidence among school-aged children. The condition does not show a significant gender preference, meaning both boys and girls are equally susceptible. Environmental factors such as exposure to cold, damp living conditions, and a weakened immune system are known to increase the risk of developing rheumatic fever.

Disease Progression and Heart Damage

The course of rheumatic fever is often prolonged and marked by recurring episodes. Over time, these repeated inflammatory attacks can lead to permanent damage to the heart valves. Studies show that between 25% and 50% of patients who experience heart involvement during rheumatic fever will develop lasting cardiac complications.

Delayed Diagnosis and Its Consequences

One of the challenges of rheumatic heart disease is that its symptoms can be subtle and may not appear until adulthood—or even later in life. Approximately half of all patients are diagnosed only after reaching maturity, which underscores the importance of early detection and timely intervention.

Why Early Detection Matters

Given the progressive nature of the disease and the potential for irreversible heart damage, early diagnosis and proper management are crucial. Timely medical care can significantly improve long-term outcomes, reduce the risk of complications, and enhance quality of life for those affected by rheumatic heart disease.