How will you treat Rheumatic Heart Disease?

Although having rheumatic fever leaves one more susceptible to heart damage, rheumatic fever does not always permanently damage the heart. However, when the inflammation caused by rheumatic fever leaves one or more of the heart valves scarred, the result is rheumatic heart disease. The mitral valve and the aortic valve are usually the ones damaged by the disease. Years later, the mitral valve may become narrowed, a condition known as mitral stenosis.

Treatment of acute rheumatic fever includes antibiotics to treat the strep infection and additional medications to ease the inflammation of the heart and other symptoms. Usually aspirin is given in large doses until the joint inflammation goes away; rarely steroids are needed. Once the acute illness has gone away, patients need to take penicillin, or an equivalent antibiotic, for many years to prevent recurrences. This is a very important treatment because the risk of heart valve damage increases if rheumatic fever recurs.

Treatment of rheumatic heart disease involves treating the damaged heart valves. Most often the valve leak caused by the disease is mild and does not need treatment. If the leak is severe enough to strain and enlarge the heart, surgery may be needed to eliminate the leak. This surgery may involve repair of the damaged valve. Sometimes the valve is too badly damaged to repair, in which case it must be replaced by an artificial valve.

How will you Diagnose Rheumatic Heart Disease?

The first step in diagnosing rheumatic heart disease is establishing that your child recently had a strep infection. The doctor may order a throat culture and/or a blood test to check for the presence of strep antibodies. However, it is likely that signs of the strep infection may be gone by the time you take your child to the doctor. In that case, the doctor will need you to try to remember if your child recently had a sore throat or other symptoms of a strep infection.

The doctor will do a physical examination and check your child for signs of rheumatic fever, including joint pain and inflammation. The doctor also will listen to your child's heart to check for abnormal rhythms or murmurs that may signify that the heart has been strained.

In addition, there are a couple of tests that may be used to check the heart and assess damage, including:

• Chest X-ray -- This allows your child's doctor to check the size of the heart and to see if there is excess fluid in the heart or lungs.

• Echocardiogram -- This test uses sound waves to measure the heart's size and shape and creates an image of the heart.

How can I prevent rheumatic heart disease?

The best defense against rheumatic heart disease is to prevent rheumatic fever from ever occurring. By treating strep throat with penicillin or other antibiotics, doctors can usually stop acute rheumatic fever from developing.

People who've already had rheumatic fever are more susceptible to attacks and heart damage. That's why they're given continuous monthly or daily antibiotic treatment, maybe for life. If their heart has been damaged by rheumatic fever, they're also at increased risk for developing bacterial endocarditis, an infection of the heart's lining or valves.

What are the symptoms of rheumatic heart disease?

Symptoms vary greatly. Often the damage to heart valves isn't immediately noticeable. A damaged heart valve either doesn't fully close or doesn't fully open.

Typically, symptoms of rheumatic fever appear about two weeks after the onset of an untreated strep throat infection. Apart from the sore throat caused by the strep infection, children have a fever and feel ill. Commonly, the child will have a very painful, swollen and red joint -- usually a large joint like a knee, ankle, elbow or shoulder -- that goes away after a day or two only to be replaced by the same findings in another joint. Short-lived skin rashes may occur, but are not common. Even if the heart is affected, it is usually not sever enough to cause symptoms, and occasionally the child may be short of breath.

Most cases of strep throat, including untreated infections, do not cause rheumatic fever. However, if rheumatic fever affects the heart valves, it can disrupt normal blood flow through the heart and cause damage to the heart.

Eventually, damaged heart valves can cause serious, even disabling, problems. These problems depend on how bad the damage is and which heart valve is affected. The most advanced condition is congestive heart failure. This is a heart disease in which the heart enlarges and can't pump out all its blood.

What is Rheumatic Heart Disease ?

Rheumatic fever is an inflammatory disease. It can affect many of the body's connective tissues — especially those of the heart, joints, brain or skin.Rheumatic heart disease is a condition in which the heart valves are damaged by rheumatic fever. Anyone can get acute rheumatic fever, but it usually occurs in children five to 15 years old. The rheumatic heart disease that results can last for life.