Rheumatic heart disease (RHD) is a condition affecting the heart valves, usually following an episode of rheumatic fever. The disease can gradually damage the heart valves, affecting blood flow and overall heart function. Early recognition and long-term care are critical to prevent complications like heart failure and stroke.
If you or a family member have a history of rheumatic fever or experience unexplained palpitations, shortness of breath, or fatigue, you can get personalised advice from licensed doctors through Hope Plus. This service helps you get timely care and reduces the risk of long-term heart complications.
Key Takeaways
- RHD usually develops after rheumatic fever and primarily affects the mitral and aortic valves.
- Symptoms may include heart failure, arrhythmias, palpitations, and strokes from blood clots.
- Some patients have no symptoms, and the condition is discovered incidentally.
- Diagnosis involves chest X-ray, ECG, and echocardiography.
- Long-term prophylaxis and management of heart failure are essential; surgery may be needed in severe cases.
Causes
- Damage to heart valves after rheumatic fever.
- Most commonly affects:
- Mitral valve: stenosis, incompetence, or both
- Aortic valve: stenosis, incompetence, or both
Symptoms and Clinical Features
- Heart failure (difficulty breathing, fatigue, fluid retention)
- Arrhythmias and palpitations
- Thromboembolic events, such as stroke
- Heart murmurs, depending on which valves are affected
- Some patients may have no symptoms and are diagnosed incidentally
- Increased cardiac demand, e.g., during pregnancy or anaemia, may trigger congestive heart failure
Differential Diagnosis
- Other causes of heart failure
Investigations
- Chest X-ray
- Electrocardiogram (ECG)
- Echocardiography (best for assessing valve damage)
Treatment
- Treat heart failure if present, following heart failure guidelines
- Long-term prophylaxis with antibiotics to prevent recurrent rheumatic fever, as outlined in rheumatic fever management
- Cardiac surgery if necessary, usually only at a national referral hospital
Prevention
- Prevention of initial rheumatic fever through early treatment of strep throat
- Lifelong adherence to prophylactic antibiotics in patients with a history of rheumatic fever
Frequently Asked Questions
Can RHD develop without symptoms?
Yes. Some people have no symptoms until complications arise, such as heart failure or stroke.
Is surgery always required?
No. Surgery is only needed in severe cases where valve damage significantly affects heart function.
How is RHD different from rheumatic fever?
Rheumatic fever is an acute condition following strep throat, while RHD is the chronic heart valve damage that can result from it.
Can RHD be prevented?
Yes. Early treatment of strep throat and adherence to prophylactic antibiotics after rheumatic fever are key preventive measures.
