Heart Disease Common Rheumatic

Rheumatic fever is an inflammatory disease that begins with a strep throat infection, the most common bacterial infection of the throat. Complications from rheumatic fever can harm connective tissue in the joints, brain, skin and sometimes the heart. When the heart valves become damaged by this disease, the effects can be lifelong. This condition is usually called rheumatic heart fever or rheumatic heart disease.

Rheumatic fever and resulting rheumatic heart disease can affect people of any age, but the condition usually strikes children between the ages of five and 15. This is not a common form of heart disease in the United States, but in the developing world, rheumatic heart fever is the leading cause of cardiovascular death for children under five (American Heart Association, 2010a).

Symptoms and Diagnosis

Before developing rheumatic heart fever, patients usually contract strep throat, a bacterial infection with symptoms that include a sore throat, painful swallowing, headache, fever, and sometimes nausea and abdominal pain.

Most sore throats occur as a result of viruses, not bacteria, and when strep throat infections occur, the symptoms are usually mild and treatable with antibiotics. But in some cases, symptoms of rheumatic fever may appear about three weeks after a strep throat infection. These can include the following:

  • Fever
  • Heart palpitations and chest pain
  • Pain that migrates from one joint to another
  • Shortness of breath
  • Small, painless nodules under the skin
  • Tender, red, swollen joints.

A diagnosis of rheumatic fever usually involves a strep throat culture and examination of the joints for pain and swelling. A doctor may also use a stethoscope to listen for murmurs or abnormal rhythms that indicate stress to the heart.

Treating Rheumatic Heart Fever

Patients can be treated with antibiotics, but after contracting rheumatic heart fever, a patient tends to be more susceptible to recurrent attacks. Also, after the heart valves have been compromised by this form of heart disease, they are more susceptible to further damage. Former rheumatic heart fever patients usually take regular courses of antibiotics to prevent bacterial endocarditis, a bacterial infection of the valves and lining of the heart. These antibiotic treatments may be required for the rest of the patient’s life.

Rheumatic Heart Disease Prevention

Penicillin and other antibiotics can usually prevent strep throat infections from evolving into rheumatic heart fever or rheumatic heart disease. As these treatments become more available, the negative outcomes related to rheumatic heart fever tend to decline.

According to the American Heart Association (2010b), about 15,000 people in the United States died of rheumatic heart fever and rheumatic heart disease in 1950. By 2006, rheumatic heart fever deaths in the United States had been reduced to 3,257. But this form of heart disease remains a serious health problem in developing nations, especially in regions where access to antibiotics may be limited.

Resources

American Heart Association. (2010a). Rheumatic heart disease/ rheumatic fever. Retrieved October 28, 2010, from http://www.americanheart.org/presenter.jhtml?identifier=4709

American Heart Association. (2010b). Rheumatic heart disease statistics. Retrieved October 28, 2010, from http://www.americanheart.org/presenter.jhtml?identifier=3066049

UCSF Benioff Children’s Hospital. (2010). Rheumatic heart disease. Retrieved October 28, 2010, from http://www.ucsfbenioffchildrens.org/conditions/rheumatic_heart_disease/

World Health Organization. (2009). Rheumatic fever and rheumatic heart disease – report of a WHO Expert Consultation. Retrieved October 28, 2010, from http://www.who.int/cardiovascular_diseases/resources/trs923/en/