The person's heart valve is damaged through a process that commonly begins with strep throat, caused by the streptococcus A bacteria, that might eventually lead to rheumatic fever.
The effects of rheumatic fever can happen to person's of any age, although they usually occur in children between the ages of five and fifteen years. Rheumatic fever is an inflammatory disease that can affect a number of connective tissues; particularly in a person's heart, skin, joints, or brain.
Rheumatic fever causes damage to a person's heart, notably scarring to the person's heart valves, forcing their heart to work harder in order to pump blood. The person might eventually experience congestive heart failure. Congestive heart failure is a condition where the person's heart is unable to pump out all of the blood that enters into it, leading to the accumulation of blood in the vessels leading into the person's heart, as well as a buildup of fluid in the person's bodily tissues. Rheumatic fever is not common in America except in children who have had strep infections that have not received appropriate treatment.
The symptoms that people experience in association with rheumatic fever vary greatly among individuals. Every person can experience symptoms differently. The symptoms usually start one to six weeks after a bout of strep throat. In some cases, the infection could be mild enough that the person does not recognize it. Symptoms of rheumatic fever can be similar to those of bone disorders or medical issues.
Symptoms of rheumatic fever include:
A first step in receiving a diagnosis of rheumatic heart disease is the establishment of a recent strep infection. A doctor might order a throat culture and/or a blood test in order to check for the presence of step antibodies in the person affected. There is a chance that the strep infection may already be gone by the time the person gets to a doctor. If this is the case, a doctor will want to know when the person experienced a sore throat or other symptoms of a strep infection.
A doctor will perform a physical examination, checking for signs of rheumatic fever. The doctor will check for inflammation of the person's joints, and listen to the person's heart for any abnormal murmurs or rhythms that could signal that the person's heart has been strained. The doctor could also order a chest X-ray to look for the size of the person's heart and whether there is any excess fluid in the person's heart or lungs. Another test the doctor could order is an echocardiogram, which uses sound waves to measure the person's heart size and shape.
Treatment for rheumatic heart disease is based upon the individual. A doctor looks at a number of things in order to define the treatment plan they will pursue for the particular person. These things include:
The best treatment for rheumatic heart disease is prevention of rheumatic fever, since rheumatic fever is the cause of the disease. Antibiotics such as penicillin are commonly used to treat strep throat caused by the streptococcus A bacterial infection, as well as to stop acute rheumatic fever from developing. People who contracted rheumatic fever in the past are many times administered continuous antibiotic treatments on either a daily or monthly basis. They may have to take these antibiotics for the remainder of their lives in order to prevent future attacks of rheumatic fever, as well as to lower their risk of heart damage. Antibiotic therapy has greatly reduced both the incidence and mortality rate associated with rheumatic fever and rheumatic heart disease.
Reduction of the inflammation related to rheumatic heart disease can involve administration of aspirin. Steroids; or non-steroidal medications, can also be used. At times, surgery is necessary in order to either repair or replace heart valves that have been damaged.