Rheumatic Fever Symptoms and Treatments

Rheumatic fever is a medical disorder that develops after a poorly treated sore throat. Strep throat is caused by a bacterium which if not treated or undertreated can lead to a variety of complications including damage to the heart. Rheumatic fever is most common in young children but on occasion the infection may involve adults. the majority of people who develop problems with the heart valves present in the 2nd or 3rd decade of life. in most cases, it is only one heart valve which is damaged but in severe cases two or more valves may be affected. Rheumatic fever is often seen in hispanics, asians, orientals and chiense who have never been adequately treated for strep throat. Very rarely is the disorder seen in the caucasian population.

Rheumatic fever had disappeared from the USA but with the recent increase in immigration, the disease has become common once again. Rheumatic fever leads to permanent damage to the heart valves and can lead to heart failure and death. The typical features of rheumatic fever include fever, joint pain, bumps on the skin, chest pain, fatigue, difficulty breathing, skin rash, abnormal movement of the hands and legs and outbursts of unusual behavior. These unusual behaviors may include inappropriate laughing, crying or gesturing. Rheumatic fever in Asia is more aggressive and tends to affect children at a much younger age.

The cause of rheumatic fever is the bacteria Group A strep. Somehow the bacteria adheres to the heart valves and initiate an inflammatory reaction which leads to destruction of the valve. If the child is promptly treated with antibiotics, there is no chance of developing this dreaded infection. Once the valve gets infected, the individual may slowly develop heart failure, abnormal heart rhythms, blood clots and heart failure. The diagnosis of rheumatic fever involves checking the blood for the group A strep, ECG and an Echocardiogram to look at the heart valves.

The treatment of rheumatic heart fever depends on the degree of heart damage. Mild cases can be treated with antibiotics and anti inflammatory drugs. Drugs like Advil and aspirin do help reduce inflammation. In rare cases, corticosteroids may be required to reduce the inflammation. Sometimes one may also require anti seizure medications to control the abnormal behavior. When medical treatment is started, follow up is close to ensure that the symptoms are subsiding. Moreover repeat echocardiograms are performed to ensure that the valve is healing.

When the valve damage is severe, open heart surgery is required to replace or repair the heart. Repair of the valve is preferred but is seldom possible. Valve replacement can be done either with a mechanical or a cloth valve. Mechanical valves do last long but one needs to take a blood thinning medication for life. Cloth valves do work well but do not last longer than 10 years. The only way to prevent rheumatic fever is to ensure that your strep throat is adequately treated with a full course of antibiotics.