RHEUMATIC HEART DISEASE

Rheumatic heart disease is a serious public health problem in India . This disease affects mainly children and young adults. The cause of the disease is rheumatic fever which can affect the joints, heart and nervous system. The effect on the joints is mild but the heart can be seriously damaged leading to deformity of the heart valves. It can produce narrowing as well as leakage of the mitral valve, aortic valve and tricuspid valve.

The basic cause for rheumatic fever is a kind of allergy to a common infection of the throat (pharyngitis) caused by bacteria called "Streptococci". If on a regular basis patient is given inj. Penicillin, the disease can be largely prevented from progressing to a stage of needing surgery of heart

This disease was at one time prevalent all over the world but presently seen largely in the developing countries like India . This is probably due to better standard of living and lesser chance of spread of streptococcal infection. In India this disease is very common and affects children and young adults. It is important to diagnose the disease early so that treatment and preventive measures can be undertaken.

What are the early complaints of the patient with rheumatic fever?
The child usually develops joint pains. There may or may not be history of swelling of the joints. Only some children confirm throat infection. The effect on the heart usually comes a few weeks after the joint pains and can be mild or severe. But it is the long term effects of the rheumatic fever that are of greatest concern and usually produce breathing difficulty, cough, inability to sleep, blood in the sputum and in late cases swelling over the body. By this time usually one or more valves are damaged and need surgery or balloon valvotomy or valve repair.

The various methods of treatment for this condition are out of scope for this article. What is important for the general public to know are:
1. Rheumatic heart disease is largely preventable by diagnosing early case.
2. Any child or teenager complaining of throat pain should be taken seriously and should be taken to a doctor for ruling out streptococcal infection by appropriate tests and if found positive treated with a course penicillin or other appropriate anti-biotic.
3. Established cases of rheumatic fever should be put on long term penicillin prophylaxis which means one injection of Benzathine penicillin once in 3 weeks. These injections have to be given upto a minimum age of 21 years and in many cases much longer.
4. Compliance to the injection of penicillin is the single most important step in preventing this disease from progressing to a life threatening stage.






Dr.K.Sarat chandra,
MD,DM,FICC.
Additional Professor,
Department of Cardiology Unit -I,
Nizam's Institute of Medical Sciences,
Panjagutta,Hyderabad- 500082.
Mobile no. - +91-9848012212
phone no.[Off]- +91-40-23302426
Fax no.[Off.] -+91- 40-23302426
saratkoduganti@yahoo.co.in