August 1- 7 is Rheumatic Fever and Rheumatic Heart Disease Awareness Week and healthcare professionals are emphasising the importance of understanding these interconnected but distinct conditions. This awareness week aims to educate the public about the causes, symptoms, prevention, and treatment of rheumatic fever and rheumatic heart disease, highlighting the critical need for early intervention and sustained healthcare efforts.
Rheumatic fever is an inflammatory disease that can develop as a complication of untreated or poorly treated streptococcal throat infections, commonly known as strep throat. It most frequently affects children between the ages of five and 15, but it can occur in adults as well. The disease can cause widespread inflammation in the body, affecting the heart, joints, skin, and brain.
• Fever
• Painful and swollen joints, often starting in the knees and ankles
• Small, painless nodules under the skin
• A rash that appears as flat or slightly raised, painless, and red patches
• Shortness of breath and chest pain, indicating potential heart involvement
• Uncontrolled movements of the arms, legs, or facial muscles (Sydenham chorea)
Rheumatic fever is typically diagnosed through a combination of medical history, physical examination, and tests such as throat cultures, blood tests for inflammation, and echocardiograms.
Rheumatic heart disease is a chronic condition that results from rheumatic fever causing permanent damage to the heart valves. The inflammation from rheumatic fever can lead to scarring of the heart valves, which can result in narrowing (stenosis) or leaking (regurgitation) of the valves. Over time, this can lead to serious heart complications, including heart failure, atrial fibrillation, and stroke.
Symptoms of rheumatic heart disease can vary depending on the severity and specific heart valve affected but may include:
• Shortness of breath, especially during physical activity or when lying down
• Fatigue and weakness
• Swelling of the legs and feet (edema)
• Chest pain
• Rapid or irregular heartbeats (palpitations)
Diagnosis of rheumatic heart disease typically involves detailed medical history, physical examination, and imaging studies such as echocardiograms, which provide detailed views of the heart’s structure and function.
Preventing rheumatic fever involves prompt and complete treatment of strep throat infections with antibiotics. Treating sore throats can significantly reduce the incidence of rheumatic fever and, consequently, rheumatic heart disease.
For those who have had rheumatic fever, long-term antibiotic prophylaxis is often recommended to prevent recurrence and further heart damage. Treatment for rheumatic heart disease may include medications to manage symptoms and prevent complications, as well as surgical interventions to repair or replace damaged heart valves.
Rheumatic Fever and Rheumatic Heart Disease Awareness Week serves as a reminder of the importance of early diagnosis and treatment of strep throat to prevent these serious conditions. It also highlights the need for ongoing medical care for those affected by rheumatic heart disease to manage their health and prevent further complications.
By increasing awareness and education, we can work towards reducing the burden of rheumatic fever and rheumatic heart disease, ultimately improving the quality of life for those at risk or affected by these preventable diseases.
Dr Lehlohonolo Dongo
Cardiothoracic Surgeon
Busamed Modderfontein Private Hospital
October 10, 2024
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