Rheumatic heart disease is lasting damage to the heart valves caused by rheumatic fever, a reaction of the body to an untreated strep throat infection. It mostly starts in children and young people and is still common in Afghanistan. It can lead to heart failure, stroke and problems in pregnancy, but it can be prevented by treating strep throat and, after rheumatic fever, by regular penicillin injections.
Symptoms
Shortness of breath with activity, and later even at rest
Tiredness
Palpitations or an irregular heartbeat
Swollen ankles or legs
Chest pain
Earlier rheumatic fever may have caused fever and painful, swollen joints that move from one joint to another
Causes
Strep throat that was not treated, or not treated with a full course of antibiotics
Repeated attacks of rheumatic fever
Crowded living conditions that help strep infections spread
A family tendency in some people
Prevention
Take children and young people with sore throat and fever to a health worker, and finish the full antibiotic course if prescribed
After rheumatic fever, get regular penicillin injections exactly as scheduled — do not miss any
Reduce crowding and keep good hygiene at home
Look after your teeth and gums to lower the risk of heart valve infection
Treatment
Regular long-acting penicillin injections for many years, as prescribed — the most important treatment
Heart medicines for breathlessness, fluid or an irregular heartbeat
Blood thinners for some people, such as those with atrial fibrillation or an artificial valve
Surgery to repair or replace a badly damaged valve
Women with rheumatic heart disease should plan pregnancy with their doctor
Do not start or stop prescription medicines without a doctor
Common questions
Why are monthly penicillin injections needed?
Each new strep infection can cause another attack of rheumatic fever and more valve damage. Regular injections prevent these infections and protect the heart. Missing injections increases the risk.
Can a woman with rheumatic heart disease have a safe pregnancy?
Many can, but pregnancy puts extra strain on the heart. She should see a doctor before or early in pregnancy, have regular check-ups, and give birth in a hospital.
