Rheumatic heart disease symptoms
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Symptoms of Rheumatic Heart Disease
Rheumatic heart disease (RHD) is a chronic condition resulting from acute rheumatic fever (ARF), which is caused by an autoimmune response to group A streptococcal infections. This disease primarily affects the heart valves and can lead to severe cardiovascular complications if left untreated. Understanding the symptoms of RHD is crucial for early diagnosis and effective management.
Early Symptoms of Rheumatic Heart Disease
Fever and Joint Pain
One of the initial symptoms of ARF, which precedes RHD, includes fever and joint pain. These symptoms typically appear 2 to 3 weeks after a streptococcal throat infection. The inflammation can affect multiple joints, causing significant discomfort and swelling.
Skin and Nervous System Involvement
ARF can also manifest through skin rashes and involuntary movements due to nervous system involvement. These symptoms are part of the systemic inflammatory response triggered by the infection.
Cardiac Symptoms
Carditis
Carditis, or inflammation of the heart, is a hallmark of ARF and a precursor to RHD. It can lead to serious complications such as heart murmurs, chest pain, and shortness of breath. In severe cases, carditis may cause heart failure and require medical interventions like diuretics and vasodilators.
Valve Damage
The most significant long-term effect of RHD is damage to the heart valves, particularly the mitral and aortic valves. This damage can result in valve stenosis (narrowing) or regurgitation (leakage), leading to symptoms such as fatigue, chest pain, and shortness of breath . Over time, this can progress to more severe conditions like pulmonary hypertension and heart failure.
Heart Murmurs and Arrhythmias
Patients with RHD often develop heart murmurs due to turbulent blood flow across damaged valves. Additionally, arrhythmias, particularly atrial fibrillation, are common and can increase the risk of stroke.
Advanced Symptoms and Complications
Heart Failure
As RHD progresses, the heart's ability to pump blood effectively diminishes, leading to heart failure. Symptoms of heart failure include severe shortness of breath, swelling in the legs and abdomen, and persistent fatigue.
Endocarditis
Patients with RHD are at an increased risk of developing infective endocarditis, an infection of the heart valves. This condition can cause fever, chills, and new or worsening heart murmurs, and it requires prompt medical treatment.
Stroke and Embolism
Due to the increased risk of atrial fibrillation and other arrhythmias, patients with RHD are more susceptible to stroke and other embolic events. This is particularly concerning in those with mechanical prosthetic valves or a history of cardioembolism.
Conclusion
Rheumatic heart disease is a serious condition that stems from acute rheumatic fever and primarily affects the heart valves. Early symptoms include fever, joint pain, and skin rashes, while advanced symptoms involve significant cardiac complications such as valve damage, heart murmurs, and heart failure. Recognizing these symptoms early and managing them effectively with appropriate medical interventions can significantly improve outcomes for patients with RHD.
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