Rheumatic Fever

Overview

Rheumatic fever is a rare progression of strep throat, where the heart valves may be damaged as the body produces antibodies to fight the strep infection. It’s become rarer thanks to the availability of medications to treat strep throat.

Symptoms

It could take months or even years for heart valve damage from rheumatic fever to produce symptoms, but the damage can have serious, even disabling, results. These problems depend on how severe the damage is and which heart valve is affected. The most serious condition is congestive heart failure, in which an enlarged heart is unable to pump enough blood to the body.

Some telltale symptoms associated with rheumatic fever aren’t related to the heart. They include:

Joint pain and swelling that moves through different joints
Skin rash, usually on the torso or arms
Painless bumps under the skin on the back of the wrist, outside the elbow, or on the front of the knees,
Tremors in the limbs

Progression and possible complications

Damage to the heart and heart valves may be temporary or permanent. It may cause narrowing (stenosis) so that the valve no longer allows enough blood to flow through. Or it may damage the valve and keep it from closing fully and allow blood to leak backward into the heart.

If caught early, the inflammation that stretches or weakens the heart muscle or injures the valves is commonly reversible.

Children with rheumatic heart disease may develop a chronic condition. Each time the disease recurs, the chances of heart valve damage increases.

If the heart has been damaged by rheumatic fever, patients also are at increased risk for developing an infection called endocarditis.

Treatment

Treatments for rheumatic heart disease include antibiotics to treat the strep infection or to prevent recurrence. A child diagnosed with rheumatic fever may need to take antibiotics until they reach adulthood to prevent future infections.

If rheumatic fever leads to suspected endocarditis, a person may be treated with aspirin, steroids, or medications that help treat congestive heart failure.

If there’s significant damage to the heart valve, your doctor may recommend surgery to repair or replace the affected valve.