Rheumatic Heart Disease

Rheumatic heart disease is a condition where the heart valves have been permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever. An immune response causes an inflammatory condition in the body. This can result in ongoing valve damage.

What causes rheumatic heart disease?

Rheumatic heart disease is caused by rheumatic fever. This is an inflammatory disease that can affect many connective tissues, especially in the heart, joints, skin, or brain. The heart valves can be inflamed and become scarred over time. This can result in narrowing or leaking of the heart valve. This makes it harder for the heart to work normally. This may take years to develop and can lead to heart failure. Rheumatic fever can occur at any age. But it often occurs in children ages 5 to 15. It’s rare in developed countries like the U.S.

Who is at risk for rheumatic heart disease?

Untreated or under-treated strep infections can increase the risk for rheumatic heart disease. Children who get repeated strep throat infections are at the most risk for rheumatic fever and rheumatic heart disease.

What are the symptoms of rheumatic heart disease?

A recent history of strep infection or rheumatic fever is key to the diagnosis of rheumatic heart disease. Symptoms of rheumatic fever vary. They typically start 1 to 6 weeks after a bout of strep throat. In some cases, the infection may have been too mild to be recognized. Or it may be gone by the time the person sees a healthcare provider.

These are the most common symptoms of rheumatic fever:

• Fever
• Swollen, tender, red and very painful joints (very often the knees and ankles)
• Lumps under the skin (nodules)
• Red, raised, lattice-like rash, often on the chest, back, and belly
• Shortness of breath and chest discomfort
• Uncontrolled movements of arms, legs, or facial muscles
• Weakness

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