Rheumatic Heart Disease: Causes, Symptoms, Diagnosis, and Treatment Essay

Rheumatic heart disease is caused by the damage to the heart valves. Unfortunately, this disease is preventable, but it can frequently occur in people who have not been properly treated for sore throats.

Moreover,

if the disease is recognized and treated early enough, it will prevent the development of severe forms of the disease.

Rheumatic heart disease refers to a condition in which the valves develop insufficiency or stenosis as a result of rheumatic fever that occurs as a complication of a streptococcal infection. This infection can cause rheumatic fever most often in children. After this infection, rheumatic valve insufficiency or stenosis develops. Each valve can independently present with three types of changes:

• stenosis

• insufficiency

• thickening of the leaflets

• the formation of scars

Most often, the mitral valve is affected by rheumatic heart disease, but the aortic and other valves can also be affected. The course of the disease is determined depending on which valves are affected.

The reason for the development of this disease is an inadequately treated streptococcal infection. More specifically, in this situation, fever and rheumatic fever develop as a result of an inadequately treated infection. The following factors are known to provoke rheumatic fever:

1. Streptococcus infection leads to tonsillitis

2. As a result of a prolonged untreated infection, the body fails to fight off the infection and rheumatic fever develops

3. Rheumatic fever provokes the development of inflammation

4. Inflammation leads to the fact that the heart valves become stiff and scarred

5. As a result of these changes, rheumatic heart disease develops

• untreated sore throat

• history of rheumatic fever

• inadequately treated sore throat

• family history of rheumatic fever

• living in an endemic area

• lack of access to medical care

The clinical picture of this disease depends on the changes in the valve and is similar to the symptoms of other heart diseases. Moreover, the symptoms may be present many years after rheumatic fever. In particular, patients with rheumatic heart disease most often experience:

• dyspnea

• weakness

• chest pain or discomfort

• palpitations

• swelling

• tachycardia

• dizziness

• sleepiness

• reduced work capacity

In addition to the above symptoms, some patients may also experience heart failure, arrhythmia, or a stroke.

It is noteworthy that rheumatic heart disease most often manifests itself in childhood or adolescence. This happens because rheumatic fever occurs in children. Moreover, in children, sore throat, if properly treated, can prevent rheumatic fever. On the other hand, those who have had rheumatic fever need lifelong antibiotic therapy to avoid recurrence.

A doctor can determine this disease based on the patient’s symptoms and physical examination. Moreover, to fully evaluate the situation, the following tests are typically prescribed:

An echo is done to determine whether there is a narrowing of the valve orifices. Using this test, the doctor evaluates the movement of the valves, the ejection fraction (EF), the size of the cardiac chambers, and the presence of stenosis. Echo also allows the doctor to look at the movement of the heart valves.

This procedure is routine and is done to confirm or exclude the presence of arrhythmia.

A chest X-ray is taken to evaluate whether the heart is enlarged or there is fluid in the lungs.

In addition to the above procedures, standard laboratory tests are also prescribed. In particular, they help determine whether a patient has a streptococcal infection or rheumatic fever. These tests enable the doctor to make an accurate diagnosis and prescribe adequate therapy.

If left untreated, rheumatic heart disease can lead to the following complications:

• dysfunction of the heart valves

• heart failure

• atrial fibrillation

• formation of blood clots, which can lead to a stroke

• pulmonary hypertension

• the need for valve replacement

The treatment of this disease is usually conservative and is aimed at eliminating the symptoms of the disease. Moreover, in some cases, surgery is indicated. The following treatments are indicated for rheumatic heart disease:

1. Antibiotic therapy: This type of therapy is used both to treat the causative streptococcal infection and as a prophylactic to prevent further episodes of rheumatic fever.

2. Drug treatment: To reduce the symptoms of the disease, the doctor may prescribe the following drugs:

• diuretics

• dehydrating agents

• drugs to improve blood circulation

• anti-arrhythmic drugs

• anticoagulants

1. Valve repair surgery is indicated if the surgeon needs to repair the valve.

2. Valve replacement surgery is indicated if the valve is beyond repair and must be replaced with a prosthesis.

This disease can be prevented in most cases. To do this, sore throats should be treated. Moreover, people who have had rheumatic fever need to be under the supervision of a doctor and take antibiotics. In addition, it is advisable to monitor the health of children and prevent rheumatic fever.

It is necessary to contact a cardiologist if the following symptoms of this disease occur:

• shortness of breath

• constant fatigue

• chest pain

• swelling

• palpitations

• decreased work capacity

In conclusion, this disease is preventable and, fortunately, with the right and timely treatment of the initial stages, patients can return to their normal lives without major problems. Moreover, the development of minimally invasive surgery for installing heart valves prostheses and stents makes it possible to treat this disease with great efficacy.