Rheumatic Heart Disease (RHD) is a chronic heart condition caused by damage to the heart valves following untreated or inadequately treated throat infection by streptococcal bacteria. The infection can trigger rheumatic fever, an abnormal immune reaction that may affect the heart, joints, skin and nervous system. Repeated inflammation can gradually damage the heart valves permanently.
The human heart contains four valves that ensure one-way blood flow through the heart chambers. In rheumatic heart disease, the most commonly affected valve is the mitral valve, located between the left upper and lower chambers of the heart. The aortic valve is the second most commonly involved. In some patients, multiple valves may be affected together.
The valve damage may cause:
- Valve narrowing (stenosis), where the valve does not open properly
- Valve leakage (regurgitation), where blood flows backward
- Or a combination of both
Mitral valve disease can lead to breathlessness, fatigue and palpitations, while severe aortic valve disease may cause chest pain, dizziness or heart failure symptoms. Over time, damaged valves can enlarge the heart chambers and increase pressure inside the lungs.
Rheumatic heart disease remains an important health problem in India and other developing countries, particularly among children and young adults. Delayed treatment of sore throat infections, overcrowding and limited healthcare access contribute to the disease burden. Many patients may not develop symptoms for years until the valve damage becomes severe.
Common symptoms include:
Shortness of breath Fatigue and reduced exercise capacity Palpitations Swelling of the legs Chest discomfort Dizziness or fainting in advanced disease
If untreated, rheumatic valve disease can lead to complications such as heart failure, stroke, atrial fibrillation and severe pulmonary hypertension.
Diagnosis is usually made through clinical examination, ECG and echocardiography, which helps assess the type and severity of valve involvement. Treatment depends on the affected valve and severity of disease. Patients may require medications, long-term penicillin prophylaxis to prevent recurrent rheumatic fever, balloon valvotomy procedures, valve repair or valve replacement surgery in advanced cases.
Early diagnosis and regular follow-up are very important, as timely treatment can significantly improve quality of life and prevent long-term complications.
ESC
