International Conference on Cardiology and Cardiovascular Medicine: Rheumatic Heart Disease (RHD): Causes, Symptoms, Complications, and Treatment

Rheumatic Heart Disease (RHD) is a serious, chronic condition that affects millions of people globally, particularly in developing countries. It results from untreated or poorly treated streptococcal infections, such as strep throat or scarlet fever, which can lead to rheumatic fever—an inflammatory disease that causes permanent damage to the heart valves.

What Causes Rheumatic Heart Disease?

RHD usually develops from a chain reaction starting with a bacterial infection. Here's how it happens:

1. Untreated or Inadequately Treated Strep Throat or Scarlet Fever

Caused by Group A Streptococcus bacteria.
If not treated properly with antibiotics, these infections can lead to further complications.

2. Rheumatic Fever

An autoimmune response where the body mistakenly attacks its own tissues, especially the heart valves.
Typically occurs weeks after a strep infection.

3. Progression to Rheumatic Heart Disease

Ongoing inflammation leads to scarring and deformities of the heart valves.
This makes it difficult for the valves to open or close properly, disrupting blood flow.

Common Symptoms of RHD

RHD may go unnoticed in its early stages. As the disease progresses, symptoms may include:

Fatigue: Persistent tiredness, even with mild activity.
Shortness of Breath: Especially during exertion or while lying flat.
Chest Pain: Can be sharp or dull; may worsen with physical activity.
Heart Palpitations: Sensation of fluttering or irregular heartbeat.
Swelling: Usually in the legs, ankles, or abdomen.
Other Symptoms: Dizziness, lightheadedness, or fainting spells.

Complications of RHD

If left untreated, Rheumatic Heart Disease can lead to life-threatening complications:

Heart Valve Disorders

Stenosis: Narrowing of the heart valves.
Regurgitation: Leaky valves that let blood flow backward.

Heart Failure

The heart becomes too weak to pump blood effectively, leading to fatigue, fluid buildup, and breathlessness.

Infective Endocarditis

Increased risk of infection in the heart lining and valves, especially in damaged tissue.

Pregnancy Complications

Women with RHD may face higher risks during pregnancy. Pre-pregnancy medical consultation is crucial.

Diagnosis and Treatment of RHD

Diagnosis

Doctors may perform:

Physical exams to detect heart murmurs.
Echocardiograms to visualize heart valve function.
Blood tests for inflammation or recent strep infections.

Treatment Options

1. Antibiotics

Used to prevent further strep infections.
Long-term antibiotic prophylaxis may be recommended.

2. Medications

Diuretics, beta-blockers, or anticoagulants may be prescribed to manage symptoms or prevent complications.

3. Surgical Intervention

Valve Repair or Replacement Surgery is often needed in advanced cases.

Prevention: The Best Strategy

How to Prevent RHD:

Prompt treatment of strep throat with antibiotics.
Regular check-ups if you've had rheumatic fever before.
Public health awareness in high-risk communities.

Global Impact of RHD

Rheumatic Heart Disease is largely preventable but remains a major health issue in low-resource settings. According to the World Heart Federation, over 40 million people live with RHD worldwide, and it causes more than 300,000 deaths annually.

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