Dr.Kamini Silvarajan MD/AAAM

Editorial Board: Kamini Silvarajan MD/AAAM

Rheumatic Heart Disease Principles

Rheumatic heart disease (RHD) is a cardiovascular problem that is caused by a streptococcal infection. It is usually initiated by an acute and recurrent rheumatic fever (RF). RF is a form of inflammatory problem that commonly affecting children.

The main culprit of RHD is beta-hemolytic streptococcus. This causative agent is aerobic. It means that any vital organ in the body that has favorable source of oxygen serves as the best reservoir for strep. These include the heart (RHD) and kidney (Acute Glomerulonephritis or AGN). 

The inflammatory process of RHD can affect the three layers of the heart. These include endocarditis (inflammation of the heart’s innermost lining), myocarditis (swelling of the cardiac muscles), and pericarditis (inflammation of the heart’s outer layer).The most common age bracket that is affected by RHD is children age between five and fifteen. 
However, some reported cases are affecting adults and elders. This simply explains that RHD does not have exclusion to children. 

What are the Diagnostic Tests for Rheumatic Heart Disease?

Early diagnosis is the best way to reduce the extent of RHD. However, people living with this condition are bound for long-term antibiotic therapy. 

Below is the illustration of common diagnostic evaluation used for rheumatic heart disease:

Name of Diagnostic - Exam - Indications for RHD 

Blood Test

The test will show suspected case of RHD if the white blood count and erythrocyte sedimentation rate is high. 

Cardiac Catheterization

The test shows that there is a problem in the cardiac function (especially the pumping action of the left side of the heart) and there is damage in the valves. 

Cardiac Enzyme Tests

The heart enzymes are high, which means that there is severe inflammation in the heart. 

Chest X-Ray

In X-Ray, the heart appears normal in shape but there might be some variable or irregular size due to the inflammation of the heart. 

C-Reactive Protein Test

The test result is positive during the acute phase of RHD. 

ECG (Electrocardiogram)

The ECG graph shows that there is prolong PR interval to almost 20% of the people living with RHD. 

What are the Prompt Treatments for Rheumatic Heart Disease?

The goals for treating RHD includes the ability to allow client maintain a normal and stable heart function. These include normal cardiac output, cardiac rate, and absence of arrhythmias (abnormal rhythm of the heart). 

In cases of infections, clients should remain free from the threat of streptococcus and becomes an active partner of health. Relieving pain is another goal for treating RHD. Lastly, health care professionals should explain the nature of RHD including the significance of complying with medical treatment. 

The most commonly prescribed medications to treat RHD are anti-inflammatories (Prednisone, Aspirin, and Non-Steroidal Anti-inflammatory Drugs), and antibiotics (Penicillin and Erythromycin). 

When using of antibiotics, expect that you will have a buzz-like type ringing sensation of ears. This is a common side effect of antibiotic for RHD. 

Bed rest is very crucial for treating RHD. You need to stay on bed until your cardiac functions remain normal. Surgical treatment is performed (Corrective Valvular Surgery) to severe cases of heart failure. Constant monitoring of the vital signs and ECG is needed. – By Edter