Rheumatic Heart Disease

Rheumatic heart disease is a condition of the heart in which its valves are damaged by an episode of rheumatic fever, an inflammatory disease produced by streptococcal agents immediately after an episode of pharyngitis that damages the connective tissues of the heart, brain, joints or skin.

Although any person can develop rheumatic heart disease, rheumatic fever is much more common in children between 5 and 15 years old. Worse yet, the effects derived from a rheumatic fever episode can last for life, and the most serious of those effects is rheumatic heart disease.

Symptoms Of Rheumatic Heart Disease

There is a wide variety of symptoms associated to rheumatic heart disease, including cardiac and non-cardiac manifestations. Symptoms of rheumatic heart disease may include dyspnea, chest discomfort or pain, severe cough, orthopnea and edema, all of those related to pancarditis. Pericarditis is another form of rheumatic heart disease, as well as rheumatic valvulitis (infection of the heart’s valves) and respiratory distress.

Pathophysiology Of Rheumatic Heart Disease

As stated above, rheumatic heart disease is caused by rheumatic fever. To understand the pathophysiology of rheumatic heart disease, we must first focus on the pathophysiology of rheumatic fever.

On pharyngitis caused by A-beta-hemolytic streptococcus, those organisms invade the upper respiratory tract and stick themselves to the local epithelial cells, liberating a variety of harmful enzymes that damage the tissues. After a short 2-4 day incubation period, the invaders precipitate a response from the immune system, which consists in a swollen throat, high fever, headaches and body discomfort. In about 3 percent of the cases, this infection turns into rheumatic fever. It is a highly contagious disease, and the patient remains infected for several weeks after symptoms subside. Penicillin shots or pills can be very helpful in curing streptococcal pharyngitis and also to prevent further episodes.

One of the biggest findings regarding the pathophysiology of rheumatic fever is that the main cause of most virulent effects of the A-group streptococcus resides in the presence of the M protein in its cellular wall. This protein is able to attach itself to the body’s connective tissues and degrade their structure.

Prevention And Treatment Of Rheumatic Heart Disease

The best way to prevent rheumatic heart disease is to prevent its causing disease, rheumatic fever. Avoiding open exposure to an infected person is recommended, although due to the nature to streptococcus and their incubation period sometimes it’s hard to detect an infected individual, especially within a school environment where children learn and play together most of the time. On infected patients, the best treatment consists on penicillin or other antibiotics. The antibiotic treatment is also recommended for people who had suffered from rheumatic fever in the past, in order to avoid any possible development of rheumatic heart disease as well as other diseases.

Bookmarks
Bookmark This |