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Rheumatic heart disease is a rare condition that appears as a complication of certain untreated infections such as strep throat or scarlet fever. Even though the condition is rare, it can be critical if left untreated. 

What Is Rheumatic Fever?

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Rheumatic fever is a serious health condition that typically affects children between the ages of five and 15. Rheumatic fever is a complication of conditions like strep throat or scarlet fever.

This isn’t a common complication since these health conditions are typically treated with antibiotics before they can spread. However, a serious infection that is left untreated for weeks can result in rheumatic fever. This complication typically appears two to four weeks after the beginning of the infection.

The symptoms of this condition include fever, joint pain, chest pain, and an irregular heartbeat. Some patients can’t control their body movements and display unusual behaviors.

Rheumatic fever isn’t fully understood, but it is believed that the immune system can’t properly target the bacteria responsible for the untreated infection and attacks healthy tissues instead. This includes heart valve tissues, joint tissues, and some of the tissues that make up the central nervous system.

Depending on how serious rheumatic fever is and how long it remains untreated, the damages can be permanent and result in heart valve disease if the heart valve tissues sustain serious damages.

Rheumatic fever can appear in children and adults, but it is more common in children and teens. Rheumatic fever is a serious condition that should be treated right away, and that will require monitoring of the heart function throughout the patient’s life.

Heart disease is a complication of rheumatic fever, but it can take years for symptoms and signs of damage to appear. Some patients are diagnosed with rheumatic fever but never experience heart problems if their tissues heal completely.

Rheumatic fever is treated with antibiotics and anti-inflammatory medications. Taking these medications as early as possible after being diagnosed reduces a patient’s risks of developing heart problems.

What Are The Symptoms Of Rheumatic Heart Disease?

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This health condition can affect the heart muscle or the heart valves. If the heart valve tissues are damaged, the term rheumatic valve disease is used.

The symptoms will vary in function of how severe the damage is and where it occurred. If the damage is limited to the heart muscle, symptoms will include low blood pressure, fatigue, and an irregular heartbeat since the heart muscle won’t be able to pump blood properly.

Rheumatic valve disease typically affects the mitral and aortic valves. It can cause leakage or valve stenosis. These are the most common symptoms associated with rheumatic heart disease:

  • Heart murmur.
  • Shortness of breath.
  • Pain chest or discomfort.
  • Dizziness and fainting.
  • Weight gain.
  • Swelling of the feet, ankles, or abdomen.

Some patients suffer from valve regurgitation, which causes blood to flow in the wrong direction. Some suffer from valve stenosis, which is characterized by a hardening and narrowing of the heart valves. Stenosis causes decreased blood flow and can be critical if blood flow to the heart muscle is reduced.

If the heart muscle or heart valves were damaged as a result of rheumatic fever, healthcare professionals would probably notice other symptoms such as damaged joint tissues.

Which Tests Are Used To Diagnose This Condition?

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A doctor can listen to a patient’s heartbeat to determine if a heart murmur is present. This is typically the first symptom that is noticed if someone suffers from a heart valve disease.

Additional tests are needed to find out more about a patient’s heart function. Echocardiography is the most common method used to study a patient’s heart valve function.

Electrocardiograms and chest X-rays can also be used, but echocardiography will be typically used to confirm the diagnosis.

The patient’s medical history plays a crucial role in diagnosing rheumatic heart valve disease. A patient who is diagnosed with rheumatic fever will go through regular testing to monitor the extent of damages heart valve tissues have sustained.

If heart valve disease is diagnosed in a young patient, a rheumatic fever will be considered as a likely cause. However, because this complication doesn’t appear unless a condition like strep throat or scarlet fever isn’t treated right away, it is possible for the patient never to have been diagnosed with rheumatic fever.

A history of serious infections that were left untreated can provide a healthcare provider with some clues and help them diagnose a patient with rheumatic heart disease.

Because heart disease is extremely rare in children and teens, the two most likely causes of heart valve problems are congenital malformations and complications from rheumatic fever. Tests can typically show whether a heart valve is malformed or whether there are scarred tissues preventing the heart muscle or a valve from functioning properly.

How Is Rheumatic Heart Disease Treated?

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One of the most important aspects of treating this condition is to prevent infections from appearing and causing more damages to the damaged heart tissues. This is why patients typically have to take antibiotics for several years.

Penicillin is often prescribed for rheumatic valve disease patients, but other antibiotics can be prescribed if a patient isn’t responding well to Penicillin.

Preventing infections is crucial because rheumatic fever can occur again and cause bacterial endocarditis to damage valve tissues as well as the lining of the heart.

A patient’s treatment plan depends on how badly the heart valves or muscle are damaged. Some treatment plans include diet and activity restrictions to promote heart health and avoid strenuous activities.

Patients might need to monitor their heart rate and blood flow and avoid certain activities that would be too strenuous for their reduced blood flow. They might also need to adopt a healthy diet low in fat and sodium and take steps to avoid gaining weight.

Staying away from alcohol and tobacco is strongly recommended since these substances can worsen heart function. Some patients can benefit from an exercise program adapted to their needs to strengthen their heart.

If the patient is still experiencing inflammation as a result of rheumatic fever, aspirin, steroids, or other treatments can be used to reduce inflammation.

A patient’s treatment plan might include measures to deal with damaged joint tissues and other complications of rheumatic fever.

Treating Heart Valve Tissue Damage

Surgeries might be needed to remove or repair damaged tissues. Replacing a damaged heart valve is another possible option if a valve isn’t functioning properly.

Heart valve replacement surgery is an invasive procedure that includes some risks. This option is usually not considered until later in the patient’s life. It is possible for damaged heart valve tissue to heal and cause a minor leak or slight stenosis that isn’t life-threatening, which is why heart valve replacement surgery is typically not considered right away.

If surgery is needed, a surgeon can sometimes improve heart valve function by removing scarred tissues. If a valve needs to be replaced, a mechanical or biological valve can be used.

A mechanical valve will require the patient to take blood-thinning medication for the rest of their lives. In some cases, it is best to replace a damaged valve with a biological valve from an animal’s heart.

If a patient’s blood flow is not severely impacted by damaged heart valve tissues, surgery might not be needed.

Once a patient is diagnosed with rheumatic fever or rheumatic valve disease, they will need to receive ongoing care and have their condition monitored regularly. The initial treatment plan should include antibiotics and other measures to prevent heart tissues from sustaining more damage.

Surgery and other treatment might be considered in the future. The initial emphasis is on limiting additional damages to a valve or heart muscle tissues, and healthcare providers will typically wait a few years to see how damaged tissues heal.

Treating Damage Heart Muscle Tissue

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Damages to the lining of the heart are not as common as damages to the heart valve tissues. However, rheumatic fever can cause a deterioration of the heart muscle.

If there is are damages to the heart muscle that don’t heal over time, there are different treatment options to explore.

A patient’s treatment plan will include prescriptions to reduce inflammation and prevent further damages to the heart muscle. Because a weakened heart muscle can cause high blood pressure and increases risks of strokes, the patient will have to adopt a heart-healthy lifestyle.

Surgically-implanted pacemakers and defibrillators can improve heart muscle function. However, surgery is typically not considered until later in the patient’s life. A team of healthcare professionals should follow patients with heart muscle tissue damage and assess how the condition is progressing.

Rheumatic heart disease is not very common, but it is important to learn to recognize the symptoms of infections and rheumatic fever. Complications such as damaged heart valve and muscle tissues can be prevented by treating infections or rheumatic fever as soon as the symptoms appear.

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