8. Rheumatic Heart Disease

Question 1

Definition

Answer 1

Damage to one or more heart valves resulting from recurrent or unresolved episodes of rheumatic fever, causing the heart to become inflamed. Affects mainly children and almost uniquely indigenous.

Question 2

Aetiology

Answer 2

Caused by recurring bouts of rheumatic fever due to untreated or unrecognised strep throat causing the heart valves to become inflamed and scarred over time, hindering the heart’s ability to function properly as the valves narrow and blood flows out. Can lead to heart disease, heart failure or death.

Question 3

Signs and symptoms of rheumatic fever:

Answer 3

Fever, raised red rash, weakness and uncontrolled movement, lumps under the skin (rheumatoid nodules)

Question 4

Signs and symptoms of RHD

Answer 4

Begin 1-6 weeks after period of strep throat.

Swollen and painful joints (knees and ankles), SOB, chest discomfort.

Question 5

Diagnosis

Answer 5

Electrocardiogram, echocardiogram, chest X-ray, cardiac MRI, blood tests, throat swabs

Question 6

Treatments:

Answer 6

Antibiotics: Monthly injections of penicillin up to 5 years. Treats rheumatic fever and prevent infections to heart valves.
Anti-inflammatory drugs, corticosteroids.
Severe cases: Surgery to repair or replace damaged heart valves
Regular check ups to monitor functioning of the heart

Question 7

Co-occurring conditions:

Answer 7

MI, stroke, arrhythmia, endocarditis (bacterial infections of heart valves).
Complications: With pregnancy and delivery