What is rheumatic heart disease?
Rheumatic heart disease is permanent damage to the heart valves that follows rheumatic fever — an inflammatory illness that can develop after an untreated streptococcal (strep) throat infection, usually in childhood. It remains an important cause of valve disease in India and many parts of the world, and it is largely preventable.
How does it develop?
When a strep throat is not treated properly, the body’s immune response can mistakenly attack its own tissues, including the heart valves. Over years, repeated inflammation can scar and deform the valves — most often the mitral valve — making them narrowed or leaky.
Symptoms
- Breathlessness on exertion
- Fatigue and reduced exercise capacity
- Palpitations
- Swelling of the ankles in advanced disease
- Many people have no symptoms for years while the valve damage silently progresses
Prevention
Treat every sore throat that your doctor diagnoses as strep throat with the full course of prescribed antibiotics — do not stop early. People who have had rheumatic fever need long-term protection (antibiotic prophylaxis) against repeat infections, guided by their doctor.
Diagnosis and treatment
An echocardiogram shows the valve damage. Treatment includes medicines to protect the heart and manage symptoms, prevention of further strep infections, and — when the valve damage is significant — mitral valve surgery or aortic valve surgery to repair or replace the affected valve. Regular cardiology follow-up is essential.
When to seek care
Call your local emergency services for severe breathlessness, chest pain or fainting.
Related: valvular heart diseases · mitral valve surgery