Sunday, October 28, 2012

All about Rheumatic Heart Disease

All about Rheumatic Heart Disease
Matters of the heart (Thinkstock photos/Getty Images)

SE Asia leads in death due to Rheumatic Heart Disease

According to World Heart Federation, in south-east Asia, rheumatic fever and rheumatic heart disease are leading cause of cardiac disability and death. A RHD global registry (REMEDY) study is currently ongoing in almost 30 centres in Africa, Middle East and India. The following facts have come forth

RHD was twice as prevalent among children aged 11-15 years (prevalence of 26.5 per 1000 children) compared to children aged 5-10 years (12.6 per 1000 children).

Girls had a higher prevalence of RHD (27.9/1000 girls) compared to boys (13.3/1000 boys).

What is RHD?

Rheumatic Heart Disease (RHD) is a chronic heart condition caused due to rheumatic fever that generally affects children and adolescents because of a vulnerable immune system. A throat infection (caused due to streptococcus bacteria) is the root cause of the disease.

The streptococci bacteria have a genetic makeup similar to the heart muscle. So, the body's defense mechanism is not able to distinguish between the bacteria and the heart muscle and attacks the latter instead. It can particularly target heart valves and heart muscle, causing these to function poorly. The good news is RHD can be prevented and controlled. A regular antiobiotic treatment plan (usually by injections every three to four weeks) can prevent rheumatic fever & patients with rheumatic fever from contracting further infections and causing progression of valve damage.

The India story

The bad news is incidence of RHD is much higher in India than the rest of the world. In India, 47 - 59% of all cardiac admission to hospitals in major urban centres are said to be attributed to Rheumatic Heart Disease.

Doctors believe that across Africa and India, it is widely known by cardiologists that many patients with RHD do not have access to the healthcare treatment they need. These results unfortunately show that even those that are being treated are not receiving the care they need, for a variety of reasons.

Red Alert: Risk factors for cardiovascular disease


Family history of cardiovascular disease

High cholesterol

High blood pressure



Poor eating habits


Lack of physical activity

Precautions for RHD

-Since RHD is caused by a rheumatic fever, deal with it first.

-The development of antibiotics such as injectable Penicillin or oral erythromycin (if the patient is sensitive to penicillin) has made rheumatic fever preventable.

-These drugs can knock out the strep before the germs get a chance to set off the inflammatory defense network sequences, but early detection is necessary.

-Among the symptoms of strep are a sore throat that comes on suddenly, with redness and swelling; rapidly acquired high fever; nausea and headaches.

-The only sure way to tell, however, is to have a throat swab taken by passing a sterile piece of cotton over the inflamed area.

-This culture is then exposed for 24 hours to a laboratory dish containing a substance that enhances strep growth. A positive identification calls for prompt treatment to kill the germs before the complications of rheumatic fever have a chance to set in.

Treating Rheumatic heart disease:

In Rheumatic heart disease, the heart valve doesn't work right- it may not open all the way (narrowing or stenosis) or may have problems closing (leaking or regurgitation).This affects the flow of blood through the heart. In such a case the valve is either repaired or replaced.

Valve repair

Repair means that the valve is mended to help it work better. During repair, a ring may be sewn around the opening of the valve to support it. In replacement, the diseased valve is removed and a new valve is inserted in its place.

Valve replacement

In replacement, the damaged valve can be replaced with either the mechanical or biological valve. Mechanical valves are made of metal and have longer durability but require additional precautions. Biological valves are made of human or animal tissue and function better but wear out earlier than metallic valves.

Times of India

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