The antibiotic treatment that is most effective in preventing further infection is benzathine penicillin G, which is given by intramuscular injection every 3-4 weeks over many years.įor countries where rheumatic heart disease is endemic, the main strategies for prevention, control and elimination include: improving standards of living expanding access to appropriate care ensuring a consistent supply of quality-assured antibiotics for primary and secondary prevention and planning, developing and implementing feasible programmes for prevention and control of rheumatic heart disease, supported by adequate monitoring and surveillance, as an integrated component of national health systems responses. The strategy to prevent additional streptococcal infection is to treat the patient with antibiotics over a long period of time. Once a patient has been identified as having had rheumatic fever, it is important to prevent additional streptococcal infections as this could cause a further episode of rheumatic fever and additional damage to the heart valves. Treatment of strep throat with appropriate antibiotics will prevent rheumatic fever. Since rheumatic heart disease results from rheumatic fever, an important strategy is to prevent rheumatic fever from occurring. This is often not available in low-income settings, or when it is available the costs may be too high if not covered as part of national health plans, putting families under increased financial strain. In the case of serious disease surgery may be required to repair or replace the heart valves. Medications which thin the blood to reduce the risk of blood clots may also be needed.
Depending on the severity of disease, medication may also be needed to treat symptoms of heart failure or heart rhythm abnormalities. Patients with severe rheumatic heart disease will often require surgery to replace or repair the damages valve or valves. There is no cure for rheumatic heart disease and the damage to the heart valves are permanent. Symptoms of heart valve damage that is associated with rheumatic heart disease may include:
#PICTURES OF SWOLLEN ANKLES DUE TO CONGESTIVE HEART FAILURE SKIN#
painless nodules under the skin near joints and/or a rash consisting of pink rings with a clear centre (both rare).jerky uncontrollable body movements called ‘chorea’.
pain that moves between different joints.painful joints especially knees ankles, elbows and wrists.It is not uncommon for women to be unaware that they have rheumatic heart disease until pregnancy.ĭespite it being eradicated in many parts of the world, the disease remains prevalent in sub-Saharan Africa, the Middle East, Central and South Asia, the South Pacific, and among immigrants and older adults in high-income countries, especially in indigenous peoples. Pregnant women with rheumatic heart disease are at risk of adverse outcomes, including heart arrythmias and heart failure due to increased blood volume putting more pressure on the heart valves. Where rheumatic fever and rheumatic heart disease are endemic, rheumatic heart disease is the principal heart disease seen in pregnant women, causing significant maternal and perinatal morbidity and mortality. People who live in overcrowded and poor conditions are at greatest risk of developing the disease. Rheumatic fever mostly affects children and adolescents in low- and middle-income countries, especially where poverty is widespread and access to health services is limited.
Rheumatic heart disease results then from the inflammation and scarring of heart valves caused by rheumatic fever.
This is what is referred to as rheumatic fever. In some people, repeated strep infections cause the immune system to react against the tissues of the body including inflaming and scarring the heart valves. Strep infections are most common in childhood. Rheumatic heart disease starts as a sore throat from a bacterium called Streptococcus pyogenes (group A streptococcus) which can pass easily from person to person in the same way as other upper respiratory tract infections.
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