All About Rheumatic Heart Disease Treatment
Learn about Rheumatic Heart Disease (RHD) treatment, including causes, symptoms, diagnosis, medications, surgeries, and lifestyle changes. Discover strategies for prevention, management, and the latest innovations in care.
Written by Dr Sonia Bhatt
Last updated on 3rd Jul, 2025
Rheumatic heart disease (RHD) is a chronic disorder which develops as a consequence of rheumatic fever, where damage has occurred to the heart valves. The illness mainly develops from autoimmune reactions caused by untreated or inadequately treated Group A streptococcal infections, including strep throat. In the long run, fibrosis and calcification of the valves occur, resulting in weakened movement and poor functioning in controlling blood flow.
If left untreated, RHD may cause severe deterioration that leads to severe heart failure, irregular heartbeat, or stroke. The disorder requires pharmacological treatment, surgical intervention if required, and alteration of personal behaviours.
Under such circumstances, timely intervention can help maintain heart health and enhance the well-being of the patients.
Causes and Risk Factors
RHD emerges as a chronic complication of rheumatic fever, an inflammatory disease affecting the heart, joints, skin, and the central nervous system. Untreated Group A streptococcal infections cause immune-mediated damage to the valves of the heart, especially mitral and aortic valves. Recurrent rheumatic fever attacks aggravate the valve disorder; thus, prevention and early management are essential.
The following population is primarily at risk:
Children and Adolescents: Children in this group aged 5 – 15 years are most susceptible to rheumatic fever, and detection in this group requires tremendous focus.
Low- and Middle-Income Regions: Crowding, lack of cleanliness, and inadequate access to proper health care result in a raised incidence of streptococcal infections and, therefore, RHD.
Genetic Predisposition: Autoimmunity seems to be predetermined in some patients, which predisposes them to RHD after a streptococcal infection.
Symptoms and Diagnosis
Some common signs and diagnosis of RHD include:
Tiredness or tiredness at rest; shortness of breath, especially during exercises.
Swelling in the legs, ankles or stomach as a result of fluid accumulation.
Chest pain which may be due to the disorder in the valve.
Feelings of pounding of the heart; any heart rhythm other than the normal steady, strong beat.
Severe cases may result in heart failure or stroke-related symptoms.
In terms of diagnosis, here are some of the tests often used:
Echocardiography: The best technology that gives powerful pictures of actual valve structure and operation.
Electrocardiogram (ECG): Identifies heart irregularities and other disturbances in heart electrical activity.
Chest X-ray: Determines the overall dimensions of the heart and the presence of fluid accumulation in the lungs.
Blood Tests: To help determine if a patient has had a recent streptococcal infection or any evidence of inflammation.
Timely diagnosis using these tools allows for early intervention, reducing the risk of complications.
Get Your Heart Health Checked
Treatment Options
Medications form the cornerstone of RHD treatment, targeting symptoms, preventing complications, and managing underlying causes:
1.Antibiotics: Effective long-term therapy to avoid further Streptococcal infection.
Anti-inflammatory Drugs: Diminish inflammation and pain during the phase of acute manifestations of rheumatic fever.
2.Diuretics and Beta-Blockers: Treat some complications such as oedema and hypertension.
3.Anticoagulants: Avoid the formation of blood clots in patients who have severe valve disease or atrial fibrillation.
In advanced cases, surgery may be required to repair or replace damaged heart valves:
4.Valve Repair: Reposition or realignment of the valve to functional anatomy for proper functioning of the body’s valves.
5.Valve Replacement: Includes replacement of the damaged valve with an artificial or human one, mechanical or biological respectively.
These procedures help provide good blood circulation, ease pain and discomfort as well as improve overall heart functions, thus greatly enhancing the quality of the patient’s life.
Preventive strategies and early management are essential for minimising the risk of severe outcomes. Long-term antibiotic prophylaxis helps prevent recurrent rheumatic fever, which could further damage the heart. Regular cardiac evaluations allow for the timely detection of worsening valve function, enabling appropriate interventions.
Role of Antibiotics
Absolute essential in the current management of RHD is antibiotics because they serve to prevent or minimise a recurrence of rheumatic fever.
For patients who have had a previous rheumatic fever, they should continue to take antibiotics to prevent future infection by streptococcal that can worsen their heart valves. Every such occurrence enhances the potential for a worsened outcome and it is therefore beneficial to use antibiotics consistently.
In patients with RHD, antibiotics such as penicillin are taken for several years depending on the severity of the disease or the patient’s age. It is now common knowledge that compliance to such regimens is not only protective of the disease but also offers futuristic protection against such adversities as heart failure or infective endocarditis.
The proper use of antibiotics is still one of the key principles in the provision of continuing care, which helps patients improve the results of treatment and quality of life in case of diseases.
Lifestyle Changes and Rehabilitation
RHD can only be well managed if a combination of a change in lifestyles and consistent rehabilitation methodologies is undertaken.
Eat plenty of fruits, vegetables, whole grains and lean proteins
Remove foods that are rich in salt, sugar and saturated fats
Participate in moderate exercise
Routine check-ups
Continuous surveillance for signs such as shortness of breath, fatigue or chest pains
Complications of RHD
Rheumatic heart disease (RHD) can lead to serious complications that significantly impact heart function and overall health.
Chronic valve damage forces the heart to work harder, often resulting in heart failure over time.
RHD can give rise to arrhythmias, infective endocarditis (a potentially life-threatening infection of damaged valves), and blood clots, which may increase the risk of stroke.
These complications not only worsen the disease but also contribute to a decline in quality of life if left untreated.
In advanced cases, surgical procedures such as valve repair or replacement are critical for restoring proper blood flow and preventing symptom progression. With proactive care, many of these complications can be effectively managed or avoided.
Prognosis and Long-term Management
The prognosis for individuals with rheumatic heart disease (RHD) varies based on the severity of valve damage, the presence of complications, and access to timely care.
Early diagnosis and consistent management, including medication, lifestyle adjustments, and surgical interventions, improve outcomes.
Proper treatment significantly improves outcomes, preventing further deterioration of heart function and reducing the risk of severe complications.
Ongoing care is vital for long-term management. Regular medical follow-ups, adherence to prescribed treatments, and attention to lifestyle factors such as diet, exercise, and stress management play a critical role. Rehabilitation programs help restore physical function, while emotional support and counselling contribute to mental well-being.
Effective management is a collaborative process between healthcare providers and patients, ensuring a comprehensive approach to improving quality of life and maintaining heart health over the long term.
Innovations and Research
Ongoing research continues to pave the way for groundbreaking solutions. Promising vaccine developments targeting Group A Streptococcus aim to address the root cause of RHD, potentially eradicating the condition in high-risk populations. Studies exploring genetic predisposition and immune mechanisms are also shedding light on personalised treatment approaches and early detection strategies. These innovations bring hope for reducing the global burden of RHD, improving patient care, and advancing preventive measures on a broader scale.
Conclusion
Rheumatic fever is one of the many diseases that can be well averted and treated, especially if detected on time. The use of antibiotics in the proper manner, alteration in lifestyle, continuous monitoring, and proper surgical interventions are the things that help slow down the progress of RHD and improve the results.
General knowledge about RHD, its causes, signs and ways to prevent it is highly necessary to minimise its effects, mainly among the most endangered groups. Combative teamwork and more research are needed in order to eliminate this condition and enhance heart health among several people around the world.
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