Rheumatic Heart Disease Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Rheumatic heart disease is permanent damage to the heart valves caused by rheumatic fever. This disease is a dangerous complication of rheumatic fever.
The heart valves are damaged due to the disease process that begins with a throat infection due to Streptococcus bacteria, which can cause rheumatic fever.
Approximately 39% of patients with acute rheumatic fever can experience abnormalities in the heart, ranging from heart valves that cannot close, heart failure, inflammation of the sac around the heart, and even death.
In patients with severe rheumatic heart disease, complications can be in the form of valvular stenosis, namely the inability of the heart valves to open wide and completely, so that blood cannot flow properly.
Symptom
Rheumatic heart disease can attack many body systems, especially the heart, joints, brain, and skin tissue. Signs and symptoms of acute rheumatic fever vary depending on the organs involved and the degree of involvement. Usually, these symptoms last 1-6 weeks after infection with Streptococcus bacteria.
Clinical symptoms of rheumatic heart disease can be:
1. Cardiac symptoms
- Abnormalities in heart sounds.
- Heart failure.
- Inflammation of the lining of the heart.
- Inflammation of the heart which is the most serious and second most common complication of rheumatic fever. In more advanced cases, patients may complain of shortness of breath, chest discomfort, chest pain, swelling and coughing.
2. Noncardiac symptoms
- Inflammation of joints in several parts of the body. These are common symptoms as well as early symptoms of rheumatic fever. Generally, joint pain starts in the large joints of the knees and ankles, then migrates to other large joints in the upper body (elbows and wrists). The affected joint will be painful, swollen, warm, and red with limited movement. These symptoms reach their peak at 12-24 hours and last 2-6 days and respond very well to aspirin. These symptoms appear more easily when sufferers are often under stress.
- The rash is characteristic and rarely found in other diseases. Because of its peculiarity, this sign is included in the rare symptoms. This condition is most often found on the trunk and limbs away from the body, not involving the face. The rash becomes more visible when covered with a warm wet towel or a warm bath, while in people with dark skin it is more difficult to see.
- A lump appears. It is usually located on the joint surfaces, especially the knuckles, knees and joints of the feet. Sometimes lumps are found on the scalp and over the vertebrae.
Other symptoms of rheumatic fever include abdominal pain, nosebleeds, fever with a temperature above 39°C with an atypical pattern, rheumatism in the lungs due to infection, and anemia.
Reason
Causative factors of rheumatic heart disease include:
- Hereditary factors
Someone who has rheumatic fever will pass on the same disease to their offspring.
- Age factor
This disease often affects children aged 5-6 years, and most often occurs in children aged 8 years. - Nutritional factors
Nutritional conditions and lifestyle also influence the spread of rheumatic heart disease. Children who are physically healthy and always adopt a healthy lifestyle will be immune to this disease. - Immune reaction
Various studies suggest that there are similarities between components found in the cell wall of Streptococcus bacteria and components in heart valves. Possibly, this is what supports the occurrence of rheumatic heart disease.
Diagnosis
A joint examination to find out signs of inflammation and measuring body temperature will usually be done by a doctor as a first step. The doctor will then examine the skin to assess the rash under the skin and listen to the heartbeat to detect any abnormal rhythms. Next, a movement test to assess whether there is involvement of the central nervous system.
If necessary, the doctor will carry out laboratory tests to detect antibody levels from Streptococcus bacteria, an electrocardiogram (EKG) examination or heart record to assess heart function, and an echocardiography to assess heart structure.
Treatment
Treatment for rheumatic heart disease depends on the type and severity of the disease. In most cases, blood thinners (aspirin) are given to prevent blood clots. Doctors usually also give beta blocker drugs to restore heart function, calcium channel blockers to lower blood pressure, and digitalis to improve heart work efficiency.
Since rheumatic fever is a cause of rheumatic heart disease, the best treatment is to prevent the recurrence of rheumatic fever. Antibiotics such as penicillin and others can usually treat infections from Streptococcus bacteria and stop the manifestations of rheumatic fever. If you have ever had rheumatic fever, you will usually be given long-term antibiotic therapy. This is to prevent rheumatic fever from arising again and reduce the risk of developing rheumatic heart disease.
To reduce the symptoms of inflammation, doctors usually give aspirin and anti-inflammatory drugs. Surgical therapy can be performed to repair and replace damaged heart valves.