Rheumatic fever is a disease that causes inflammation of the joints and the heart. If untreated, it can lead to rheumatic heart disease, heart failure, severe disability and even death. Rheumatic fever begins with a sore throat, caused by bacteria called streptococci (“strep sore throat”). This is often seen in school-age children and is easily passed from child to child. A child with strep sore throat has a sudden sore throat and a high fever (over 38 °C or 100 °F). The back of the child’s mouth and tonsils become very red and swollen. Painful and tender nodes or lumps develop under the skin of the neck, which can be felt by touching.
If strep sore throat is not treated, it can develop into rheumatic fever. Rheumatic fever causes swelling and pain (arthritis) in large joints, such as the knees and elbows. It also causes swelling and pain in the heart muscle and close properly. The abnormal heart function or heart failure that this damage causes is called rheumatic heart disease.
Who is at risk of rheumatic heart disease?
Acute rheumatic fever usually occurs in children aged 5 to 15 years, after one or more attacks of strep sore throat. Rheumatic fever is more frequent in children whose close family members have had rheumatic fever. Anyone who has had one or more attacks of rheumatic fever is very prone to develop rheumatic heart disease. With each repeat attack, the heart valves become more damaged.
What should I do to prevent rheumatic fever from developing?
The best defence against rheumatic heart disease is to prevent rheumatic fever. If you think that you, your child, or another family member has strep sore throat, go to the doctor as soon as you can. Treating strep sore throat with penicillin or other antibiotics can usually prevent acute rheumatic fever from developing. It also stops the infection spreading to others at home or at school.
Note: If the patient is allergic to penicillin, be sure to tell the doctor right away so that he or she can prescribe a different antibiotic.
What are the signs of rheumatic fever and rheumatic heart disease?
There are signs of fever – high temperature, tiredness, weakness, and lack of appetite. There may also be pain and swelling in the joints and shortness of breath – a sign that the heart is not working normally. A doctor may be able to detect an abnormal heart ‘murmur’ when listening to the heart.
Treating rheumatic fever and rheumatic heart disease:
Diagnosing rheumatic fever or heart disease involves taking a history of the person’s past health, a physical examination, and blood and other tests, such as an electrocardiogram, chest X-ray, and echocardiogram. Then, the doctor will give short-term treatment to slow or stop the disease and relieve symptoms. Children who have had rheumatic fever need long-term treatment and care, including the following:
• Treatment to prevent repeat fever. A return of the fever will do more harm to the heart. Penicillin or other drugs can be used to prevent this. The drugs are given once a month as injections or daily, as tablets. Children who have had rheumatic fever need to keep taking penicillin for 5 to 10 years, or even longer, depending on the advice of the doctor.
• Treatment for rheumatic heart disease. If rheumatic heart disease has developed, the doctor will prescribe medicine. The doctor may also recommend surgery to repair damaged heart valves. After surgery there is an increased danger of blood clots forming in the heart, so anticoagulant medicines to thin the blood are given to prevent this.
• Treatment for irregular heartbeat. Some patients with rheumatic heart disease also have irregular heartbeat, called atrial fi brillation. This can increase the risk of blood clots forming, so the patient must take anticoagulant medicines.
• Treatment for infection. Patients with rheumatic heart disease have a greater chance of getting infections of the inside walls of the heart, called infective endocarditis. These infections can occur as a result of surgery or dental procedures. Patients must check with their doctor before having any such procedure.
If strep sore throat is not treated, it can develop into rheumatic fever. Rheumatic fever causes swelling and pain (arthritis) in large joints, such as the knees and elbows. It also causes swelling and pain in the heart muscle and close properly. The abnormal heart function or heart failure that this damage causes is called rheumatic heart disease.
Who is at risk of rheumatic heart disease?
Acute rheumatic fever usually occurs in children aged 5 to 15 years, after one or more attacks of strep sore throat. Rheumatic fever is more frequent in children whose close family members have had rheumatic fever. Anyone who has had one or more attacks of rheumatic fever is very prone to develop rheumatic heart disease. With each repeat attack, the heart valves become more damaged.
What should I do to prevent rheumatic fever from developing?
The best defence against rheumatic heart disease is to prevent rheumatic fever. If you think that you, your child, or another family member has strep sore throat, go to the doctor as soon as you can. Treating strep sore throat with penicillin or other antibiotics can usually prevent acute rheumatic fever from developing. It also stops the infection spreading to others at home or at school.
Note: If the patient is allergic to penicillin, be sure to tell the doctor right away so that he or she can prescribe a different antibiotic.
What are the signs of rheumatic fever and rheumatic heart disease?
There are signs of fever – high temperature, tiredness, weakness, and lack of appetite. There may also be pain and swelling in the joints and shortness of breath – a sign that the heart is not working normally. A doctor may be able to detect an abnormal heart ‘murmur’ when listening to the heart.
Treating rheumatic fever and rheumatic heart disease:
Diagnosing rheumatic fever or heart disease involves taking a history of the person’s past health, a physical examination, and blood and other tests, such as an electrocardiogram, chest X-ray, and echocardiogram. Then, the doctor will give short-term treatment to slow or stop the disease and relieve symptoms. Children who have had rheumatic fever need long-term treatment and care, including the following:
• Treatment to prevent repeat fever. A return of the fever will do more harm to the heart. Penicillin or other drugs can be used to prevent this. The drugs are given once a month as injections or daily, as tablets. Children who have had rheumatic fever need to keep taking penicillin for 5 to 10 years, or even longer, depending on the advice of the doctor.
• Treatment for rheumatic heart disease. If rheumatic heart disease has developed, the doctor will prescribe medicine. The doctor may also recommend surgery to repair damaged heart valves. After surgery there is an increased danger of blood clots forming in the heart, so anticoagulant medicines to thin the blood are given to prevent this.
• Treatment for irregular heartbeat. Some patients with rheumatic heart disease also have irregular heartbeat, called atrial fi brillation. This can increase the risk of blood clots forming, so the patient must take anticoagulant medicines.
• Treatment for infection. Patients with rheumatic heart disease have a greater chance of getting infections of the inside walls of the heart, called infective endocarditis. These infections can occur as a result of surgery or dental procedures. Patients must check with their doctor before having any such procedure.
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