Compared with the commonly heard terms of coronary heart disease (or coronary heart disease) and hypertensive heart disease, many people may be less familiar with rheumatic heart disease. See The name may even remind you of Rheumatoid arthritis. In fact, “rheumatic” refers to all diseases caused by autoimmunity or inflammation, and rheumatic heart disease is mainly caused by inflammation caused by bacterial infection.

This article will take you through the causes, symptoms, treatment and prevention of rheumatic heart disease.

What is rheumatic heart disease?

Before understanding rheumatic heart disease, first understand the related disease “Rheumatic fever”. Rheumatic fever is an inflammatory disease caused by infection with Group A β-hemolytic streptococcus. Streptococcal infection can cause strep throat (Streptococcal pharyngitis) or scarlet fever (Scarlet fever). This bacteria carries a certain protein that is similar to the protein in some human tissues, allowing the immune system to attack these bacteria while also It causes damage to human tissue. If the patient is not properly treated, streptococcal infection may develop into rheumatic fever, causing damage to the heart, joints, skin and brain, and eventually rheumatic heart disease.

Generally speaking, streptococcal infections that occur outside the throat are less likely to cause rheumatic fever. Rheumatic fever most commonly affects children and adolescents aged 5 to 15 years, but not everyone who develops rheumatic fever will develop heart problems. In fact, strep throat is a common disease. As long as it is treated promptly, it is not likely to cause damage to the heart. However, it is more dangerous in developing countries where medical resources are scarce.

Rheumatic heart disease symptoms

Rheumatic fever usually strikes within one to six weeks after a strep throat infection. Since rheumatic fever may cause heart disease, the symptoms of rheumatic fever and rheumatic heart disease are listed below:

1. joint pain
   
2. fever
   
3. Redness and swelling of joints
   
4. A small, painless lump under the skin
   
5. angina pectoris
   
6. eart murmur
   
7. Erythema marginatum
   
8. Uncontrollable body movements, such as chorea (Sydenham chorea)
   
9. Subcutaneous nodule
   

Heart disease symptoms:

1. Arrhythmia
   
2. Difficulty breathing, rapid breathing
   
3. tired
   
4. Dizziness
   
5. Swelling in the abdomen, legs, and ankles

Diagnostic methods for rheumatic heart disease

Doctors usually first use a stethoscope to determine whether there is a heart murmur. If a patient’s heart valves are damaged due to rheumatic fever, a heart murmur may occur due to friction when blood flows through the valves. In addition, doctors may also use the following methods to check whether patients have rheumatic heart disease:

1. Blood test:
   Blood test can detect streptococcal antigens or antibodies, or doctors can also learn about the inflammatory response through C-reactive protein (C-reactive protein) and erythrocyte sedimentation rate (Erythrocyte sedimentation rate) in the blood. Inflammation in the body.
   
2. Echocardiography:
   Use ultrasound to examine the heart chambers and valves to observe whether the valves are damaged, prolapsed or regurgitated, or have cardiac hypertrophy problems.
   
3. Electrocardiography (ECG or EKG for short):
   By attaching electrode patches to the chest, legs, arms, etc., the electrocardiogram instrument is used to detect the potential changes of the heart, such as activity intensity and activity time, to observe whether there is any arrhythmia. situation.
   
4. Chest X-ray:
   An X-ray machine shows the condition of the heart and lungs.
   
5. Cardiac MRI:
   Uses magnetic fields and radio waves to create detailed images of the heart to more accurately observe the condition of the heart valves and heart muscle.

Risk of rheumatic heart disease

Rheumatic fever is not prevalent in developed countries, but if you live in an environment with limited medical resources, you may need to pay special attention, especially children and adolescents. (Added video on the same scene: High-risk groups for heart disease ~ Self-examination and improvement)

1. Family history:
   Some genetic genes may increase the risk of rheumatic heart disease.
   
2. Poor sanitary environment:
   Streptococcus is easily spread in crowded environments with poor sanitary conditions. These environments often lack good medical resources, leading to an increased risk of rheumatic fever.
   
3. Young people:
   5 to 15 years old are the most susceptible age group for rheumatic fever. If you find that your child has persistent sore throat, please seek medical examination as soon as possible.
   
4. Recurrent infections:
   Recurrent streptococcal infections increase the risk of rheumatic heart disease.

Complications of rheumatic heart disease

1. Heart failure:
   Damage to the heart valves due to rheumatic fever may cause valve stenosis or prolapse, causing the heart to work harder to pump blood, increasing the risk of cardiac hypertrophy and even heart failure.
   
2. Infective endocarditis:
   Also known as bacterial endocarditis, if bacteria enter the blood and travel along the bloodstream to the heart, they may cause holes or scabs in the heart valves, or they may attach to the heart. The lining of the heart becomes infected.
   
3. Heart valve rupture:
   This is an emergency situation and valve repair or replacement surgery should be performed as soon as possible to maintain normal heart function.
   
4. Valvular heart disease:
   The inflammatory reaction caused by rheumatic fever most often damages the heart valves, causing the valves to become scarred due to the inflammatory reaction, leading to valvular heart disease.

Treatment methods for rheumatic heart disease

For rheumatic fever symptoms, doctors may use antibiotics in combination with other medications. If the heart valve has been damaged, surgery may be needed to repair or replace the valve. The following are treatments for rheumatic heart disease:

1. Antibiotics:
   Antibiotics can treat streptococcal infections and avoid or prevent further expansion of rheumatic fever symptoms. For example, penicillin (Penicillin) is a very common drug for treating rheumatic fever. Children or teenagers with heart damage from rheumatic fever may need to take antibiotics every day until they are 25 to 30 years old to avoid reinfection with rheumatic fever and to reduce bacterial damage to the endocardium and valves.
   
2. Anti-inflammatory drugs:
   Doctors may use drugs such as aspirin, Naproxen, and corticosteroids to reduce inflammation and reduce damage to the heart.
   
3. Drugs to treat heart failure:
   If heart failure is caused by rheumatic heart disease, the doctor may use Angiotensin Converting Enzyme Inhibitors (ACEI), beta-blockers (β-Blockers), and diglutinol Digoxin (also known as digitalis) and other drugs can lower blood pressure, relax blood vessels, and reduce the burden on the heart.
   
4. Anti-epileptic drugs:
   If rheumatic heart disease causes excessive involuntary body movements, your doctor may prescribe anti-epileptic drugs to reduce spasticity. Examples include Valproic acid or Carbamazepine

Rheumatic heart surgery

Heart valve damage is the reason why most rheumatic heart diseases require surgery. Depending on the degree of valve damage, traditional or minimally invasive surgery can be used to repair it, or it can be replaced with an artificial valve. There are two types of artificial valves: biological valves and mechanical valves. Doctors will evaluate the patient’s needs and physical condition and make recommendations. For more information on valve surgery, see Valvular Heart Disease.

Preventive methods for rheumatic heart disease

Avoiding streptococcal infections is the main way to prevent rheumatic heart disease. Maintaining good hygiene habits, such as washing hands frequently, covering your mouth and nose when coughing or sneezing, staying away from people with cold symptoms, changing your toothbrush regularly and avoiding sharing it with others, and wearing a mask can reduce the chance of infection. Once you notice signs of infection, seek medical advice as soon as possible and follow your doctor’s instructions for treatment. Never stop taking medication on your own as this may increase your risk of rheumatic fever or even allow bacteria to develop resistance.
​