Rheumatic heart disease
Rheumatic heart disease is lasting damage to the heart valves caused by rheumatic fever, a reaction of the body to an untreated strep throat infection. It mostly starts in children and young people and is still common in Afghanistan. It can lead to heart failure, stroke and problems in pregnancy, but it can be prevented by treating strep throat and, after rheumatic fever, by regular penicillin injections.
Symptoms
- Shortness of breath with activity, and later even at rest
- Tiredness
- Palpitations or an irregular heartbeat
- Swollen ankles or legs
- Chest pain
- Earlier rheumatic fever may have caused fever and painful, swollen joints that move from one joint to another
Causes
- Strep throat that was not treated, or not treated with a full course of antibiotics
- Repeated attacks of rheumatic fever
- Crowded living conditions that help strep infections spread
- A family tendency in some people
Prevention
- Take children and young people with sore throat and fever to a health worker, and finish the full antibiotic course if prescribed
- After rheumatic fever, get regular penicillin injections exactly as scheduled — do not miss any
- Reduce crowding and keep good hygiene at home
- Look after your teeth and gums to lower the risk of heart valve infection
Treatment
- Regular long-acting penicillin injections for many years, as prescribed — the most important treatment
- Heart medicines for breathlessness, fluid or an irregular heartbeat
- Blood thinners for some people, such as those with atrial fibrillation or an artificial valve
- Surgery to repair or replace a badly damaged valve
- Women with rheumatic heart disease should plan pregnancy with their doctor
- Do not start or stop prescription medicines without a doctor
Common questions
Why are monthly penicillin injections needed?
Each new strep infection can cause another attack of rheumatic fever and more valve damage. Regular injections prevent these infections and protect the heart. Missing injections increases the risk.
Can a woman with rheumatic heart disease have a safe pregnancy?
Many can, but pregnancy puts extra strain on the heart. She should see a doctor before or early in pregnancy, have regular check-ups, and give birth in a hospital.