Rheumatic Heart Disease

Content provided by the Faculty of the Harvard Medical School

Rheumatic Heart Disease

Question:

What is rheumatic heart disease? What are the signs or symptoms?

Answer:

Rheumatic heart disease describes the damage to heart valves as a consequence of having "rheumatic fever."

Rheumatic fever is seen rarely in the United States today. It was common a generation or two ago, particularly among children. It is still seen with some frequency in some Third World countries.

The damage to the heart valves usually does not show up until many years after the bout of rheumatic fever.

Rheumatic fever results from the body's attempt to fight infection with streptococcus bacteria, usually "strep throat." The body's response leads to inflammation that affects the heart, joints, and other parts of the body.

The damage to the heart's valves can worsen over years, so that the valves become narrowed (stenotic) or leaky (regurgitant) or both. Narrowed or leaking heart valves due to rheumatic fever or other forms of heart disease, can cause people to become short of breath or to faint. By making the heart work harder, damaged heart valves can make the heart thicken or enlarge.

Damage to heart valves due to rheumatic heart disease is sufficiently unique that the diagnosis can usually be made with an echocardiogram. Some people with rheumatic heart disease do not recall having rheumatic fever. The illness was probably too subtle to be noticed.

People with heart damage due to rheumatic fever often need surgery to replace or repair the valves.

Thomas Lee, M.D., is the chief executive officer for Partners Community HealthCare Inc. He is a professor of medicine at Harvard Medical School. He is an internist and cardiologist at Brigham and Women's Hospital. Dr. Lee is the chairman of the Cardiovascular Measurement Assessment Panel of the National Committee for Quality Assurance.

Last updated:	July 20, 2009