Overview of 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.

Rheumatic Heart Disease Statistics

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
What Is Rheumatic Heart Disease?

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.
  • 94% 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.

Symptoms

Signs and Symptoms

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
Rheumatic Heart Disease Symptoms

Treatment for Rheumatic Heart Disease

There are several treatments that may be required if you have RHD, ranging from medications through to surgery, depending on the severity of your condition.

It is important to discuss all your treatment with your doctor or nurse as well as your family.

Diagnostic tests: the medical team looking after 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: 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.

Prevention and Support

Follow the links below to find out more about how you can help prevent and support loved ones who have experienced Rheumatic Heart Disease

Prevention

Prevention

Prevention for RHD is quite different to typical Heart Disease prevention measures, as prevention tends to be focused on in a stage-based approach aiming to prevent the precursor, ARF
Supporters

Supporters

A support group is a good way to meet other people who have Rheumatic Heart Disease. Speaking to people who have a similar condition to you can help the healing process
Carers

Carers

If you are struggling to care for a loved one who has Rheumatic Heart Disease reach out discuss how you feel with someone. Your well being and health is important too

FAQs

What you need to know

Women are 2x more likely to be diagnosed with RHD than men. Furthermore, if woman have a history of RHD it can result in a complicated pregnancy, therefore you should maintain regular contact with all your doctors if wishing to fall have a baby if you have RHD.

If you have RHD, long term you may need to take medications as well as maintain a good level of hygiene to prevent further infection and complications.

It is also important to attend regular check-ups with your doctors in order to reduce the risk of needing further major treatment such as heart valve surgery.

It would also be a good idea to see your doctor every time you have symptoms of a strep infection, such as a sore throat and fever.

If you are diagnosed with RHD, we recommend speaking with your doctor and treating team to learn more about daily management.

Research suggests that attending a Secondary Prevention Program for managing Heart Diseases can decrease the chance of being admitted to hospital, reduce your complications as well increase survival rates.

One suggestion is cardiac rehabilitation, as these programs will teach you more about your disease, help you recover, empower you to make lifestyle changes to improve heart health as well as reduce your risk of further problems.

Click here to find your nearest cardiac rehabilitation program.

Your doctor may have recommended that you take some new medications if you have RHD.

This could be an overwhelming time for you, especially as learn all about your new medications as well as any considerations for taking them.

Apart from having a discussion with your doctor and pharmacist, NPS Medicinewise has some great information on medication management, medication disposal as well as risk factors.

They also have some great information about medications for your heart, which can be found here.

It’s not too late to start looking after your heart health, even after a diagnosis of RHD.

Here are some great and easy everyday strategies you can do to look after your heart health:

Don’t smoke, as quitting smoking can reduce your risk by 50% in one year. Quitline would be a great way to start your quitting smoking journey.

Stay active, 30 minutes per day of exercise, such as walking, can reduce your risk by 30% and delivers many positive health benefits. More information about exercise as well as a sample walking session can be found here.

Get some sleep, aim for 7-8 hours sleep and aim to try and unplug from your technology (e.g. iPad) one hour before bedtime. The Sleep Health Foundation has many great women’s focused sleep pages for all stages of your life such as your menstrual cycle, pregnancy, new mothers and menopause.

Eat healthy: ensure you watch portion sizes, eat healthy and nourishing foods such as: high fibre foods (including oats and legumes), two pieces of fruit and seven serves of vegetables, reduced salt, three serves of fish per week, reducing saturated fats (such as chicken with skin on, baked goods, fried foods) whilst choosing more lean proteins such as tofu and trimmed meats. The Baker Heart and Diabetes Institute has created some handy factsheets to help you choose correct portions, supermarket shopping, healthy snacks and eating out.

Relax: try and take some time out for yourself, keep connected with friends and family, perhaps try activities such as meditation to help manage your stress levels. Beyond Blue has a great page full of practical stress relieving tips, and it could be worth to try some meditations from apps such as Smiling Mind, Headspace and Calm.

There are support groups and resources for people living with ARF or RHD. Here are some recommended ones:

Rheumatic Heart Disease Australia has a great page about managing ARF and RHD for individuals and families, disease registries in Australia so your doctors can help keep track of your condition.

Take Heart is a non-for profit promotion and awareness group for RHD, you can access stories and videos about RHD.

RHD FAQs