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Rheumatic Heart Disease / Rheumatic Fever

Rheumatic heart disease or rheumatic fever is an inflammatory disease caused by an infection with streptococcus bacteria. This bacterial infection may lead to more serious symptoms.

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Rheumatic Heart Disease / Rheumatic Fever

Rheumatic heart disease or rheumatic fever is an inflammatory disease caused by an infection with streptococcus bacteria. This bacterial infection usually causes strep throat and may lead to more serious symptoms including permanent damage to the heart including damaged heart valve and heart failure. Rheumatic fever can occur in any range of age but mostly affects the children between the age of 5 and 15 years old. Treatment for rheumatic fever aims to decrease the damage from the inflammation , relieve the pain and other symptoms as well as prevent the recurrence of the disease.

Symptoms

People with rheumatic fever may experience signs and symptoms that relate to the heart, joint, skin or central nervous system fluctuate. The signs and symptoms may include:

  • Fever
  • Painful and tender joint especially in knees, ankles, elbows and wrists
  • Hot or swollen joint
  • Painless bumps beneath the skin
  • Painless rash
  • Chest pain
  • Heart murmur
  • Fatigue
  • Sydenham chorea or uncontrollable body movements
  • Unusual behavior, such as inappropriate laughing or crying


When to see a doctor

You are advised to bring the children to see the doctor if they have:

  • strep throat
  • swallowing pain
  • fever
  • headache
  • stomach pain
  • nausea
  • vomiting


Causes

A throat infection from a streptococcus either in the throat or the skin are the cause of rheumatic fever. The bacteria attacks the immune system that results in an inflammation of tissues including the tissues of the heart, joints, skin, and central nervous system. Strep throat or scarlet fever are the early episodes of the inflammation. If left untreated, rheumatic fever might develop.

Risk factors

There are some factors that can increase the risk of rheumatic fever including:

  • genetic factor
  • strep bacteria
  • environmental factors that allow strap bacteria to spread easily, such as overcrowding and poor sanitation.


Complications

Rheumatic fever may last for a few weeks to several months but it can cause numbers of long-term complications including:

  • Damaged heart valve. Rheumatic fever can cause damages of the heart valve that decrease blood flow. The damages might include:
    • narrowed heart valve
    • leak in the heart valve
  • Damaged heart muscle. The inflammation may weaken the heart muscle that affects an ability of the heart to pump.

These complications might lead to serious heart conditions, such as atrial fibrillation and heart failure.

Diagnosis

Diagnosis of rheumatic fever is a combination of medical history, a physical exam and several tests that might include:

  • Swab test
    The doctor usually uses a throat swab test with children and might not requirst another bacterial test.
  • Blood tests
    The doctor may require a blood test to
    • Detect antibodies to the strep bacteria
    • Check for inflammation
  • Electrocardiogram (ECG or EKG)
    ECG or EKG is used to record electrical signals in the heart to
    • Search for abnormal electrical activity
    • Determine an enlarged area of the heart
  • Echocardiogram
    The doctor may use echocardiogram to create images of the heart that allow the doctor to detect heart problems.


Treatment

Treatment for rheumatic fever aims to

  • destroy the bacteria
  • relieve symptoms
  • control inflammation
  • prevent the recurrence of the disease

The treatment may include several kinds of medications including antibiotics, anti-inflammatory drugs and anticonvulsant medications.

Preparing for an appointment

Before your appointment,  you are advised to be aware of restrictions prior the appointment and you may prepare some information of your child including:

  • The symptoms
  • Recent illness
  • All medications, vitamins, and other supplements taken
  • Questions that you want to ask the doctor

During the consulting, the doctor may ask some questions including information such as:

  • The beginning of the symptoms
  • The change of the symptoms over time
  • Experience of the flu or cold
  • Experience of strep throat
  • History of being diagnosed with strep throat or scarlet fever
  • The consumption of antibiotics prescribed as the treatment for strep throat or scarlet fever.

Published: 25 Oct 2020

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