What is Rheumatic Heart Disease?

Rheumatic heart disease (RHD) is the most common acquired heart disease in children in many countries in the world, especially in developing countries. This Rheumatic Heart Disease Week, 4 – 10 August, the Heart and Stroke Foundation SA (HSF) is putting the spotlight on this forgotten killer. Here’s what you need to know…

According to Dr Vash Mungal-Singh, CEO of The Heart and Stroke Foundation South Africa, Rheumatic heart disease (RHD) is the leading cause of acquired heart disease in children and young adults in South Africa.
RHD is a chronic heart condition caused by rheumatic fever which is an autoimmune reaction to an untreated streptococcal infection, known as strep throat. Rheumatic fever occurs somewhere between two and four weeks after a strep throat.

Symptoms of strep throat

  • Sore throat
  • Pain when swallowing
  • Swollen glands

Symptoms of rheumatic fever

  • Tiredness
  • Joint pain
  • Fever
  • A rash often visible on the chest

Who is at risk of rheumatic fever?

Rheumatic fever commonly strikes young children between the ages of five to 15 years. It causes inflammation and damage to several parts of the body, particularly the heart, joints and central nervous system. About 60% of all acute rheumatic fever cases will develop into rheumatic heart disease.
If left untreated, rheumatic fever can lead to severe heart valve damage. This heart valve damage can result in stroke, congestive heart failure and death.

The decline of rheumatic fever in developed countries is believed to be the result of improved living conditions and availability of antibiotics for treatment. Overcrowding, poor housing conditions, undernutrition and lack of access to healthcare play a role in the persistence of this disease in developing countries.

Treatment for strep throat and rheumatic fever

Controlling a strep throat is effective and inexpensive. Antibiotics can treat a strep throat preventing the development of rheumatic fever.
For those who develop rheumatic fever, regular antibiotic injections can prevent them from contracting further strep infections and causing progressive damage to heart valves.

Treating rheumatic heart disease

Treatment for rheumatic heart disease is expensive and complicated, and can even involve the replacement of heart valves. A heart valve replacement can cost around R50 000. Many South Africans may die whist awaiting this life-saving operation.
Fortunately the World Health Federation has developed a detailed action plan to reduce 25% of the premature deaths from rheumatic fever and RHD in young people under the age of 25 by 2025.

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