Does your child often have a sore throat or a runny nose? Or do you remember when you were a child, you used to have a sore throat with a fever? Most of the time, we don't think of these as common illnesses, do we? But did you know that if not treated properly, a simple throat infection like this can lead to a serious illness that can damage your heart in the future? That is what we call rheumatic heart disease, or `(Rheumatic Heart Disease)`. Today, we will talk about this very simply, in a way that you can understand.
What exactly is Rheumatic Heart Disease?
Simply put, rheumatic heart disease is a condition called 'Rheumatic Fever' that causes permanent damage to the heart valves. Now you may be asking, "So what is rheumatic fever?"
Imagine that our body gets a bacterial infection. Especially diseases like strep throat or scarlet fever, which are caused by a bacteria called Group A Streptococcal (GAS). When these bacteria enter the body, our body's defense system, the immune system, starts to fight them off. But sometimes this fight goes awry. Our defense system gets mixed up with the bacteria and our own healthy cells.
At this point, the immune system, as well as attacking the bacteria, starts attacking parts of our own body, especially the heart, joints, skin, and brain. This causes inflammation throughout the body. This is what we call rheumatic fever .
This inflammation can damage the delicate valves in the heart. Heart valves are like doors. They open and close properly to allow blood to flow in only one direction. Rheumatic fever can cause these valves to become scarred, narrowing (stenosis) or not closing properly, allowing blood to leak backward (regurgitation). This is when the heart valves are permanently damaged, and we call it Rheumatic Heart Disease .
The important thing is that this damage doesn't happen all at once. It's only after the throat infection has set in and the rheumatic fever has come and gone, many years later, perhaps 10 or 20 years later, that heart symptoms begin to appear.
What are the symptoms of this disease?
As mentioned earlier, many people develop symptoms very slowly. They only become apparent after a period of time after the onset of rheumatic fever. These symptoms usually appear in young adulthood.
| Symptom | Simple explanation |
|---|---|
| Difficulty breathing | It becomes difficult to breathe when exercising, at rest, or when lying down. This happens because the lungs are affected when the heart cannot pump blood properly. |
| Chest pain | You may feel tightness or pain in your chest because your heart has to work harder. |
| Palpitations | The heart feels like it is beating fast or irregularly. It feels like something is fluttering inside the chest. Sometimes, an irregular heartbeat condition such as atrial fibrillation may occur. |
| Body swelling | The abdomen, legs, ankles, and hands may swell. This is caused by fluid accumulation in the body when the heart's pumping function is weakened. |
| Frequent fatigue | Because parts of the body don't receive enough oxygenated blood, you constantly feel tired and unable to do anything. |
| Abnormal heart sounds (Heart Murmur) | When a doctor examines with a stethoscope, he may hear an unusual sound caused by blood flowing through the damaged valve. |
| Coughing up blood | This is a fairly serious symptom. It can occur when the pressure on the heart increases and affects the lungs. |
Is this disease contagious? Who is at higher risk?
No. Rheumatic heart disease is not spread directly from person to person. However, the streptococcal throat infection that causes it is. This bacteria can spread through the air when you sneeze or cough.
So, who is at increased risk of developing this disease?
- For those who get frequent throat infections and don't take antibiotics for them properly: especially during childhood.
- For those living in areas with limited healthcare facilities: Those who do not have access to a doctor and receive medication are at higher risk.
- For those living in crowded, unsanitary environments: Infections are more likely to spread in such places.
In developed countries like America, where antibiotics are given immediately after strep throat, rheumatic fever and rheumatic heart disease are now very rare. However, in countries like ours, especially in rural and densely populated areas, this condition is still a serious health problem.
What are the long-term effects of rheumatic heart disease?
Over time, damage to the heart valves can increase, leading to various complications.
- Heart Failure: A condition in which the heart is unable to pump enough blood to the body.
- Irregular heartbeat (Arrhythmia): Irregular heartbeat due to conditions like `Atrial Fibrillation`.
- Infective Endocarditis: This is a very dangerous condition where germs from the blood enter the already damaged valves and cause an infection.
- Pulmonary Hypertension: Increased pressure in the blood vessels that carry blood from the heart to the lungs.
- Stroke and blood clots: Irregular heartbeats can cause blood clots to form inside the heart, which can travel to the brain and cause a stroke.
It is especially dangerous for pregnant women who have rheumatic heart disease. During pregnancy, the body's blood volume increases, causing the heart to work harder. A heart with damaged valves may have difficulty handling this extra load. This can lead to serious health problems for both the mother and the baby.
How does the doctor diagnose this disease?
When you tell your doctor about your symptoms, he or she will examine you carefully. In particular, they will listen to your heart with a stethoscope and check for any unusual sounds (murmurs). In addition, they will ask you if you have ever had a sore throat or fever as a child.
Several tests can be done to confirm the disease:
- Blood tests: Check for inflammation in the body or changes in the functioning of the immune system.
- Chest X-ray: Check to see if the heart is enlarged or if there are signs of a heart attack.
- Echocardiogram: This is the most important test. It is like an ultrasound scan of the heart. It can clearly see how damaged, narrowed, or leaking the heart valves are.
- Electrocardiogram (ECG): Records the electrical activity of the heart and checks for irregular heartbeats.
What are the treatment options?
Many people wonder if this disease can be completely cured. The truth is, the damage to the heart valves caused by rheumatic heart disease cannot be reversed. This means it is a permanent condition . However, with good treatment, you can control the symptoms, prevent the disease from getting worse, and live a normal life.
Treatment methods can be divided into several main parts.
| Treatment method | What are you doing? |
|---|---|
| Medication | Medications are given to control heart failure, control irregular heartbeats, and remove excess fluid from the body. If there is a risk of blood clots, blood thinners (anticoagulants) may be given. |
| Minimally Invasive Procedure | If the mitral valve of the heart is narrowed, there is a method to widen the valve without surgery, using a thin tube inserted through the leg, such as a balloon. This is called Valvuloplasty . |
| Heart Valve Surgery | If the disease is severe, the damaged valve may need to be repaired or completely removed and an artificial valve or tissue valve may need to be implanted. |
Most importantly: How to prevent this disease?
Yes, this is the most important part of this article. Rheumatic heart disease is a completely preventable disease. There is one very simple thing you can do to prevent it.
Getting proper antibiotic treatment at the earliest stage of a streptococcal throat infection.
If you or your child has any of the symptoms below, please don't just stay home and think it's something simple. See a doctor immediately.
- High fever
- Sore throat
- Tonsillitis
- Joint pain
- Muscle pain
- Skin lumps or lesions
- Uncontrolled shaking of the limbs or head (Chorea)
If the doctor tests and confirms that it is a bacterial infection, he will prescribe antibiotics for a few days. It is essential to take the medication exactly for the prescribed period. Do not stop halfway through the treatment just because the pain has subsided. Doing so will not completely kill the bacteria and will increase the risk of developing rheumatic fever.
If you already have rheumatic heart disease, repeated throat infections can increase the damage to your heart. Therefore, your doctor may recommend that you take a monthly penicillin injection for a long time, perhaps for the rest of your life, to prevent infections.
Take-Home Message
- Rheumatic heart disease is caused by an untreated bacterial throat infection that occurs in childhood.
- This disease causes permanent damage to the heart valves. This damage cannot be reversed.
- Symptoms such as shortness of breath, chest pain, fatigue, and leg swelling appear years after the onset of the disease.
- Don't ignore a sore throat or fever, especially in children. See a doctor immediately and, if necessary, take antibiotics for the full prescribed period.
- If you have rheumatic heart disease, follow your doctor's instructions and treatment exactly. Go for regular medical checkups.
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