Rheumatic Fever: Understanding Causes, Recognizing Symptoms, and Seeking Appropriate Treatment
Rheumatic fever (RF) is an inflammatory disease that can develop as a complication of a Group A streptococcal infection, primarily affecting children and young adults. The most serious long-term complication of RF is rheumatic heart disease (RHD), which involves permanent damage to the heart valves.
Rheumatic fever typically appears after a streptococcal infection, and symptoms may include sore throat, headache, swollen, tender lymph nodes, trouble swallowing, nausea and vomiting, red skin rash, high temperature, swollen tonsils, abdominal pain, and fatigue. In some cases, around 10% of patients with RF develop a red, blotchy, skin rash.
The main cause of RF is Group A streptococcus (GAS), but not all strains of streptococcal bacteria will lead to RF. Additional tests can detect specific strep infections. Diagnosis of RF involves asking about symptoms, recent medical history, and specific tests like Electrocardiogram (EKG), Echocardiography, and blood tests.
Long-term complications of rheumatic fever and RHD include permanent heart valve damage, heart failure, arrhythmias, infective endocarditis, blood clots, stroke, pulmonary embolism, and pulmonary hypertension. Recurrent rheumatic fever episodes increase the severity of heart damage and the risk of chronic complications.
Risk factors associated with rheumatic fever and RHD include untreated or inadequately treated streptococcal throat infection, young age, socioeconomic factors, repeated streptococcal infections, and genetic susceptibility. Inflammation of the heart can lead to chest pain, palpitations, a sensation that the heart is fluttering or pounding hard, panting, shortness of breath, and fatigue.
Leaving strep throat or scarlet fever untreated or partially treated by not finishing a complete course of antibiotics increases the risk of RF significantly. Genetic factors may also increase the risk of RF.
Fortunately, in today's world, thanks to routine treatment of Strep throat, RF now only occurs in about cases per every 1,000 children in mainland U.S. Anyone who had RF as a child should inform their doctor as heart damage can appear many years later. If a patient with Strep bacteria takes a complete course of antibiotic treatment, the chances of RF developing are very low.
Anticonvulsant medications like valproic acid, carbamazepine, haloperidol, and Risperdal can treat severe chorea symptoms in RF patients. In 8 out of 10 cases, the signs and symptoms of RF resolve within 12 weeks. Between 30 and 45 percent of people with RF will develop heart problems. Recurrences of rheumatic fever often occur within 5 years.
The prognosis of rheumatic heart disease depends on the severity of valve damage, adequacy of medical treatment, and access to surgical interventions such as valve repair or replacement. Early diagnosis and appropriate management with antibiotics, anti-inflammatory drugs, and surgery can improve outcomes and extend life expectancy.
Worldwide, RHD is responsible for thousands of deaths per year. It is crucial to raise awareness about the importance of timely and effective treatment of strep throat infections to prevent the development of rheumatic fever and its long-term complications.
- Some patients with Rheumatic Fever (RF) may develop a chronic kidney disease, a serious long-term complication.
- Regular check-ups with a healthcare professional are important for those who had RF as children, as heart damage can manifest many years later.
- In addition to antibiotics, therapies for neurological disorders like haloperidol and Risperdal can help manage severe chorea symptoms in RF patients.
- CBD, a compound found in cannabis, has shown promise in managing certain chronic diseases, including cardiovascular health conditions.
- Medical-conditions like strep throat and rheumatic fever are best treated with a complete course of antibiotic treatment to reduce the risk of RF and its complications.
- The scientific community should focus on raising awareness about the importance of timely and effective treatment of strep throat to prevent the global spread of Rheumatic Heart Disease (RHD) and its associated deaths.
