What is Rheumatic Heart Disease?
Before understanding what Rheumatic Heart Disease is, it is also important to understand Acute Rheumatic Fever, as this illness is the precursor to Rheumatic Heart Disease.
What is Acute Rheumatic Fever?
Acute Rheumatic Fever (ARF) is a condition which occurs when your body sends out an autoimmune response when you have a group A streptococcus (strep) bacterial infection.
In simpler terms, if you have a strep infection, your immune system will instead create an inflammation-like response in your body, which can result in some unpleasant symptoms.
Not only would you experience typical strep infection symptoms (such as a sore throat and skin sores), you would also experience ARF signs such as:
- Fever
- Jerky body movements
- Skin rash on your abdomen and chest
- Joint pain and swelling around the knees, feet and ankles
- Heart swelling which can lead to chest pain and fluid build-up in the legs
- Nodules (painless lumps) on areas such as wrists, elbows, knees, ankles and even on sections of your spine
ARF is often seen in children aged between 5-14 years of age however it can be known to reoccur in people in their 40s.
What is Rheumatic Heart Disease?
Rheumatic Heart Disease is a condition where you have long-lasting heart valve damage after one or more illness episodes of ARF.
One or more of your heart valves may be left with scarring or even stretching, leading to issues with your blood flowing properly.
When these valves are damaged, your blood may either backflow into your heart’s chambers or may become stuck and not be able to be pumped out through your valves.
For more information on valve disease, please click on the Her Heart section on valvular diseases.
Complications
There are a number of complications which have been linked to RHD:
- Heart Failure, a condition where the heart’s pumping function is impaired.
- Infective endocarditis, which is an infection to your damaged heart valves
- Stroke, as clots can form in your enlarged or damaged heart valves and then travel to your brain.
- Arrhythmias (such as AF), where your heart is in an abnormal rhythm
- Pregnancy complications
- Early death in young adults
- Disability as well reduced quality of life
Statistics
- It is estimated that at least 15.6 million people worldwide are living with RHD, with the burden tending to be within developing nations.
- RHD is 2x more likely to affect women than men, and women are more likely to be affected during childbearing years.
- Despite being a wealthy and prosperous nation, Australia has a high rate of RHD, particularly among Aboriginal and Torres-Strait Islander populations, as well as immigrants who have arrived from developing nations.
- 95% of the RHD cases diagnosed in Australia are people from an Aboriginal and Torres-Strait Islander background.
- Aboriginal and Torres-Strait Islander populations are 20-55x more likely to die from RHD than their non-Indigenous counterparts.
Signs & symptoms of Rheumatic Heart Disease
The signs and symptoms of RHD appear to be a combination of infection-like symptoms as well as symptoms of Heart Valve Disease.
Here are some of the common signs and symptoms of RHD:
- Fever
- Shortness of breath
- Oedema (swelling of fluid) in the ankles and legs
- Fainting
- Orthopnea (when you cannot lay down due to breathing problems)
- Chest pain
- Palpitations
Treatment for Rheumatic Heart Disease
There are several treatments that may be required if you have RHD, ranging from medications to surgery, depending on the severity of your condition.
It is important to discuss all your treatments with your doctor or nurse as well as your family.
- Diagnostic tests: The medical team looking after you may need to do a series of tests to see if you have ARF or RHD. These include blood tests, an ECG (heart rate and rhythm trace), an ECHO (ultrasound of the heart) as well as swabbing your throat for strep infections.
- Antibiotics:Â Typically, you will receive an antibiotic treatment regime to help fight any infection of ARF or any infection on your heart valve. If you have had ARF or RHD you may need antibiotic injections every 3-4 weeks to prevent further infection.
- Other medications: You may need medications for other associated conditions including fever, pain, stroke risk and heart failure.
- Heart valve surgery: You may need open heart surgery to repair your damaged heart valves depending on the severity of your symptoms.
- Personal hygiene: Ensure you wash and shower regularly to prevent the spread of infection, wash your hands regularly to keep them clean and keep any breaks in the skin (such as cuts or sores) clean and covered.
- Regular dental visits: Visit your dentist every year and look after your teeth as tooth infections can lead to ARF or RHD.
- Regular check-ups with your doctors: Attend regular appointments with your doctors to ensure they are monitoring your heart and helping you manage your condition.
- Ask for help to improve your living situation: Bacterial infections such as strep can be easily transmitted through body fluid exposure such as coughing. Living in cramped conditions with many people can facilitate that spread of bacteria. If possible, try to improve your living environment to reduce risk of infection.
What you need to know
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