Rheumatic heart disease (RHD)

Rheumatic heart disease is a serious condition that is usually caused by an infection in childhood, though it may not be diagnosed until years later. It’s especially dangerous in areas that have poor health care and limited access to antibiotics. In such areas, it’s a major cause of cardiovascular death among children and young adults.

At Advocate Health Care, your child will receive prompt care for conditions that may lead to rheumatic heart disease.

Which infection is usually the beginning of rheumatic heart disease?

Rheumatic fever is an infection that leads to rheumatic heart disease (RHD). Children occasionally get rheumatic fever after they have a strep A infection (streptococcal pharyngitis or strep throat).

Rheumatic fever is an autoimmune inflammatory disease that usually happens during childhood. It causes rheumatic heart disease when inflammation from the infection damages heart valves and muscle tissue. Heart damage becomes more likely when a child has more than one episode of rheumatic fever.

Any damage caused by rheumatic heart disease is permanent. When heart valves are damaged, they may become scarred and narrowed.  

Who is at risk for rheumatic heart disease?

Girls and women are two times more likely to be affected by rheumatic heart disease than boys and men. People in developing countries are more at risk from rheumatic heart disease because of these factors:

• Limited access to health care and antibiotics
• Possibility of having repeated strep infections that don’t get treated
• Living in overcrowded conditions with poor sanitation

Rheumatic heart disease symptoms

Rheumatic fever can affect your child’s skin, joints, brain and heart. When it causes rheumatic heart disease, your child might have heart symptoms while rheumatic fever is present. More often, RHD isn’t identified until adulthood. Some of the symptoms of rheumatic heart disease are:

• Chest pain
• Shortness of breath
• Swelling of the hands, feet or abdomen
• Fatigue
• Rapid or irregular heartbeat (arrhythmia)
• Heart murmur

When a pregnant woman has rheumatic heart disease, it can be dangerous for her and her baby. During pregnancy, a woman has much more blood circulating through her body. The extra blood flow puts more pressure on the heart and can lead to irregular heartbeats and heart failure.

Rheumatic heart disease diagnosis

To diagnose your child’s heart condition, their provider will start with a physical exam. You’ll be asked about your child’s potential rheumatic heart disease symptoms and any history of fevers or bacterial infections.

How do you test for rheumatic heart disease?

Your child’s provider may order different tests, although no single test will confirm rheumatic heart disease. Blood samples may be used to test for inflammation or high levels of immune cells.

Cardiac imaging such as chest X-rays, an echocardiogram or an EKG will identify whether your child has normal heartbeat rhythms and potential signs of heart failure. Imaging also helps detect permanent heart valve damage. Damaged heart valves may not open wide enough to allow enough blood flow or may not close well enough to prevent blood from leaking backwards through the valve.

Rheumatic heart disease treatments

Rheumatic heart disease treatment often includes the use of medications to help your child’s heart work correctly. They may receive medications to treat arrhythmia or related heart failure, or to reduce the risk of blood clots.

When a child has serious heart damage they may need heart surgery to repair or replace damaged heart valves.

Preventing rheumatic heart disease

The key to preventing rheumatic heart disease is in promptly diagnosing and treating any strep A throat infection. It’s important to stay in touch with your child’s primary care provider whenever they’re sick so you know when to seek medical care. By treating strep infections promptly, you can prevent rheumatic fever and therefore prevent rheumatic heart disease.

Contact us with your questions about heart care for your child. We offer second opinions.

Find an  Advocate Children's heart center location near you.