Rheumatic Heart Disease / Rheumatic Fever What are rheumatic heart disease and rheumatic fever?

Rheumatic (roo-MAT'ik) heart disease is a condition in which the heart valves are damaged by rheumatic fever. Rheumatic fever begins with a strep throat (also called strep pharyngitis). Strep throat is caused by Group A Streptococcusbacteria. It is the most common bacterial infection of the throat. Rheumatic fever is an inflammatory disease. It can affect many of the body's connective tissues especially those of the heart, joints, brain or skin. Anyone can get acute rheumatic fever, but it usually occurs in children five to 15 years old. The rheumatic heart disease that results can last for life. The incidence of rheumatic fever/rheumatic heart disease is low in the United States and most other developed countries. However, it continues to be the leading cause of cardiovascular death during the first five decades of life in the developing world. What are the symptoms of strep throat? Symptoms include (but are not limited to):

sudden onset of sore throat pain on swallowing fever, usually 101104F headache red throat/tonsils abdominal pain, nausea and vomiting may also occur, especially in children

In some people, strep throat is very mild with just a few symptoms. Also, sore throats are caused more often by viruses than by a strep infection. Viral throat infections dont raise the risk of rheumatic fever and are not treatable with antibiotics. What are the symptoms of rheumatic fever? Symptoms may include:

fever painful, tender, red swollen joints pain in one joint that migrates to another one heart palpitations chest pain

shortness of breath skin rashes fatigue small, painless nodules under the skin

The symptoms of rheumatic fever usually appear about three weeks after the strep throat. How can I prevent rheumatic heart disease? The best defense against rheumatic heart disease is to prevent rheumatic fever from ever occurring. By treating strep throat with penicillin or other antibiotics, doctors can usually stop acute rheumatic fever from developing. People who've already had rheumatic fever are more susceptible to recurrent attacks and heart damage. That's why they're given continuous monthly or daily antibiotic treatment, maybe for life. If their heart has been damaged by rheumatic fever, they're also at increased risk for developing infective endocarditis (also known as bacterial endocarditis), an infection of the heart's lining or valves. In 2007, the American Heart Association updated its guidelines for prevention of endocarditis and concluded that there is no convincing evidence linking dental, gastrointestinal or genitourinary tract procedures with the development of endocarditis. The prophylactic use of antibiotics prior to a dental procedure is now recommended ONLY for those patients with the highest risk of adverse outcome resulting from endocarditis, such as patients with a prosthetic cardiac valve, previous endocarditis, or those with specific forms of congenital heart disease. The guidelines no longer recommend prophylaxis prior to a dental procedure for patients with rheumatic heart disease unless they also have one of the underlying cardiac conditions listed above. Antibiotic prophylaxis solely to prevent endocarditis is no longer recommended for patients who undergo a gastrointestinal or genitourinary tract procedure.
http://www.americanheart.org/presenter.jhtml?identifier=4709 year published : 2010