Rheumatic Heart Disease

Most of us shrug off a sore throat. A bit of irritation, maybe a fever, and usually it fades without much thought. But here’s the catch: when strep throat isn’t treated properly, it can quietly set off a chain of events that may surface years later as a serious heart condition. That condition is known as Rheumatic Heart Disease (RHD). It’s not something you hear about often, yet the impact can be life-changing.

Where It Begins

Rheumatic heart disease doesn’t come out of nowhere - not usually, anyway - it’s the aftermath of a chain reaction that gets triggered off, maybe, by something as mundane as strep throat. It’s the effect of Group A Streptococcus bacteria. In most cases, the body wipes it out without lasting damage, but in some unfortunate people, the immune system goes haywire. It doesn’t merely attack the bacteria where they are, as it should, but attacks the body instead. That misplaced immunity can ignite rheumatic fever, a condition that causes sore joints and rashes. In the worst case scenario it gets to the heart.

As soon as the heart muscle itself becomes involved, problems begin. The valves, which are supposed to open and shut cleanly, may become scarred or deformed. As the years pass, this scarring can restrict the opening (stenosis) or cause the valves to be incompetent (regurgitation). Either deformity compels the heart to work harder than it should to keep the blood flowing, and without attention, that additional stress primes the heart for serious problems.

Who’s More at Risk?

The risk of RHD increases if you:

• Previously had strep throat without being treated.
• Experienced recurrent strep infections as a kid.
• Live in densely populated or less clean situations where infection passes around easily.
• Have relatives who dealt with rheumatic fever or heart problems

Teenagers and young kids are usually most hurt by strep infections. But this is the problem, heart-valve damage usually doesn't become noticeable until years after the infection, sometimes even until adult years.

Warning Signs to Watch

Rheumatic heart disease comes quietly, usually going undetected until years afterward. The body, nonetheless, will finally offer little warnings. It may be difficult to breathe, even during exertion or lying down. Others feel an odd chest tightness, while some experience a recurring tiredness that no rest, sleeping, or eating seems to alleviate. Ankle, leg, or even stomach swell, and the beat of the heart becomes irregular or distractingly fast. In most instances, a doctor first detects some giveaway symptoms, a heart murmur while conducting a routine physical.

The problem, of course, is that the symptoms are so easy to confuse with any other condition. That is why routine medical check-ups are still important, especially people who have had rheumatic fever.

How Doctors Diagnose It

When there is a suspicion that a person has RHD, physicians will also order some tests to determine the heart’s functioning. Echocardiograms (the ultrasound of the heart) are routine, as are ECGs, used to monitor heart rhythms, chest X-rays, used to determine the heart’s size, as well as blood tests that check for antibodies related to strep or the presence of inflammation.

Early diagnosis of catching valve damage can significantly impact the degree to which it may be treated.

Treatment and Management

Treatment truly relies on the extent of damage caused to the heart valves. It can include:

• Antibiotics to help prevent future strep infections
• Anti-inflammatory drugs to soothe flares
• Medicines such as diuretics, beta-blockers, or anticoagulants to reduce the heart’s workload.

If the injury is severe, then balloon valvuloplasty (opening up blocked valves) or even valve repair/replacement surgery may be required. Outcomes range individually, so talking about all choices, and risks, with a medical team is important.

Prevention Is the Best Medicine Still

At the end of the day, the simplest prevention of stopping RHD is the early treatment of strep throat with antibiotics. For those who have already had rheumatic fever, long-term preventive antibiotics are often prescribed to lower the risk of another episode and further heart damage.

Spreading awareness matters here: what feels like a simple childhood throat infection can, if ignored, echo into lifelong consequences.