Rheumatic heart disease, commonly called rheumatic fever, is a condition that develops as a result of a streptococcal bacterial infection. This disease causes damage to the heart valves, and this damage can be permanent. Rheumatic fever can develop if infections caused by streptococcal bacteria, particularly bacterial infections such as strep throat or scarlet fever, are not adequately treated or treated.

The body's immune system reacts to a streptococcal infection, and in some cases, this response can cause a widespread, inflammatory reaction throughout the body. This reaction can lead to damage, particularly to the heart valves. Damage to these valves is called rheumatic heart disease.

Acute rheumatic fever can affect various parts of the body, most commonly the heart, joints, brain, and skin. Rheumatic fever can develop if strep throat, scarlet fever, or skin infections are not treated properly or adequately.

Therefore, early diagnosis and treatment of streptococcal infections are crucial. Untreated streptococcal infections can increase the risk of rheumatic fever and lead to serious damage to heart valves. To prevent this, prompt treatment of streptococcal infections is crucial.

At what ages does rheumatic heart disease occur?

Rheumatic fever is most common in children between the ages of 5 and 15. This is the age group when rheumatic fever is more common. The disease is more common in childhood, especially in school-aged children.

However, rheumatic fever can rarely occur in children younger than 3 years of age or in adults. The incidence of rheumatic fever in these age groups is very low. The disease usually occurs in childhood, particularly between the ages of 5 and 15, and is more common during this period.

How does rheumatic heart disease develop?

Rheumatic fever is often associated with infections caused by group A streptococcus bacteria. This type of bacteria is contagious and can cause symptoms such as a sore throat. People often contract this infection through contact with people in crowds or public spaces.

Rheumatic fever is known to begin 1 to 6 weeks after a streptococcal throat infection (also known as strep throat). Symptoms and signs during this period can vary.

Rheumatic heart disease is a condition in which rheumatic fever causes permanent damage to the heart valves. Untreated strep throat or scarlet fever can damage the heart valves. Symptoms of rheumatic heart disease can develop over time, and if left untreated, permanent damage can occur.

Rheumatic fever is not an infection that can be transmitted from one person to another. However, people infected with group A streptococcus can transmit this bacteria to others. Rheumatic fever occurs as a post-infectious immune response. In this case, people share not the infection itself, but the immune response to the infection.

What are the symptoms of rheumatic fever?

1. Fire
2. Arthritis : Pain, tenderness, and swelling, usually in the knees, ankles, elbows, and wrists.
3. If there is heart involvement:

• Chest pain
• Shortness of breath
• rapid heartbeat
• Heart failure symptoms

4. Fatigue
5. Symptoms of chorea: Uncontrollable body movements, tremors.
6. Rarely, rashes in the form of nodules (painless lumps) or pink rings with a clear center appear near the joints.

In case of rheumatic heart disease that may develop after rheumatic fever, the following symptoms may be observed:

• A new heart murmur
• Enlargement of the heart
• Fluid accumulation around the heart

These symptoms, if they suggest rheumatic fever or rheumatic heart disease, warrant consultation with a healthcare professional. These conditions can be serious, so early diagnosis and treatment are crucial.

How is rheumatic heart disease diagnosed?

• Throat culture or blood test: These tests may be done to check if the patient has had a recent group A streptococcal infection. These tests can determine whether the infection is present or not.
• Physical examination: During the examination, your doctor may listen for signs such as a heart murmur or friction rub. A murmur can be heard as the sound of blood passing through damaged heart valves. A friction rub is caused by the movement or friction of inflamed heart tissue.
• Echocardiogram (ECHO): This is used to evaluate the heart's chambers, valves, and blood flow. An echocardiogram can reveal signs such as backflow of blood through damaged valves, fluid accumulation around the heart, or an enlarged heart. It is the most commonly used test to identify heart valve problems.
• Electrocardiogram ( ECG ): Used to detect heart rhythm disturbances. In some cases, it can help identify heart muscle damage.
• Cardiac MRI (Magnetic Resonance Imaging): Can be used when necessary for detailed evaluations such as heart valves and heart muscle.

These tests are often used together to accurately diagnose rheumatic heart disease, along with the tests and examinations recommended by your doctor. This helps determine the severity of the disease and the most appropriate approach to treatment.

How is rheumatic heart disease treated?

Treatment for rheumatic heart disease generally includes the following:

• Antibiotics: Used for the prevention and treatment of rheumatic fever. Early and appropriate use is recommended, especially in treating potential infections such as streptococcal infections. This can prevent possible recurrences of rheumatic fever and the progression of heart damage.
• Anti-inflammatory medications: Doctors may give people with rheumatic heart disease aspirin, steroids, or nonsteroidal anti-inflammatory drugs to reduce inflammation.
• Heart failure treatment: If heart failure develops, heart failure medications may be used to treat the condition.
• Antibiotic prophylaxis: People with damaged heart valves may be given antibiotics for a specific period or for life to prevent recurring infections and reduce the risk of further heart damage.
• Surgical intervention: In severe cases of rheumatic heart disease, progressive heart damage may require surgical repair or valve replacement.

Treatment plans may vary depending on the patient's condition, the severity of symptoms, and the extent of heart damage. People with rheumatic heart disease should maintain a healthy lifestyle, along with regular follow-up with their doctor and adherence to recommended treatment plans.

Can rheumatic heart disease be prevented?

Yes, rheumatic heart disease is a preventable condition. It can be prevented by taking effective precautions, especially against streptococcal infections, and by using appropriate antibiotics when treating infections. Some important points include:

• Antibiotic therapy: When treating streptococcal infections, it's crucial to use the correct dose and duration of antibiotics. Antibiotic therapy should be taken regularly as prescribed and completed for the recommended duration.
• Regular follow-up with a doctor: People with rheumatic heart disease should have regular check-ups with a doctor. These check-ups are essential for monitoring the condition of the heart and heart valves and updating the treatment plan as needed.
• Preventing recurring infections: Taking preventive measures against streptococcal infections can reduce the risk of rheumatic heart disease by preventing recurring infections. These measures may include personal hygiene, reducing contact with infected individuals, and resting at home during illness.
• Monitoring at-risk individuals: Individuals with a history of rheumatic fever should be more vigilant against streptococcal infections. If symptoms appear or infection is suspected, they should consult a doctor immediately.

It should not be forgotten that rheumatic heart disease can be prevented and risks can be reduced by taking preventive measures, applying the correct treatment and regular follow-up.

What are the complications of rheumatic heart disease?

Some complications of rheumatic heart disease include:

• Heart failure: Damage to heart valves can prevent the heart from functioning efficiently. Narrowed or leaky valves can make it harder for the heart to pump blood effectively, increasing the risk of heart failure.
• Bacterial endocarditis: Rheumatic fever damages the heart valves, increasing the risk of the inner lining of the heart becoming infected. This can lead to bacterial endocarditis, an infection of the heart valves that can cause serious health problems.
• Pre-pregnancy planning: Women with rheumatic heart disease should discuss pregnancy planning with their doctors beforehand, depending on the extent of their heart valve damage. This planning is designed to minimize the risks of heart disease during or after pregnancy.

These complications are important health issues that individuals with rheumatic heart disease should be aware of and must be managed with appropriate monitoring and treatment. It's especially important to stay under medical supervision to minimize risks, especially during special circumstances like pregnancy.