How To Avoid Complications Of Rheumatic Heart Disease?
How To Avoid Complications Of Rheumatic Heart Disease?
Introduction
In India, around 26% of all adult deaths is attributed to cardiovascular diseases, including rheumatic heart disease. Despite being a preventable condition, poor access to health care in certain areas of India are contributing to higher incidence rates. Here is a detailed look at the condition, and tips to avoid complications.
Overview Of RHD Heart Disease
This belongs to the category of serious conditions due to damage to the heart valves from rheumatic fever. This is, in turn an autoimmune response to strep throat infections. It is important to note that there is no cure for rheumatic heart disease but the condition can be managed effectively to prevent adverse outcomes.
Causes of RHD – this is usually after episodes of poorly treated or untreated rheumatic fever. The immune response of the body, tackles this untreated/poorly treated infection by wrongly attacking heart tissues. This causes inflammation and scarring of the heart valves
Symptoms of RHD – include the following:
- Difficulty breathing.
- Pain in the chest.
- Tiredness.
- Abdominal swelling.
- Irregular heartbeats.
RHD can be mostly prevented by timely diagnosis and suitable treatment of strep throat. Countries with good health care and living conditions have lesser prevalence rates.
What Is The Best Approach To Rheumatic Heart Disease Management?
Managing rheumatic heart disease involves a combination of actions. For instance, the ideal approach will include preventive measures, treatment, and, wherever required, surgical intervention.
Preventive measures – can be broadly classified as primary and secondary.
- Primary prevention can be labelled as the best approach to managing RHD. This refers to prevention of rheumatic fever, through timely treatment of streptococcal throat infections using antibiotics such as penicillin.
- Secondary prevention is intended for patients with rheumatic fever. This involves administration of prophylactic antibiotics to prevent future episodes. This may require to be administered for as long as 10 years or till the age of 40.
Medical management – includes medications to tackle symptoms and complications. This involves the use of diuretics for fluid retention, and anticoagulants to prevent the formation of blood clots. Other medicines prescribed are for managing heart rhythm disorders
Surgery – is intended for patients classified as severe cases of RHD. This refers to conditions with damaged heart valves, requiring repair or replacement.
What Are The Common Rheumatic Heart Disease Clinical Manifestations?
Rheumatic heart disease may cause different types of clinical manifestations, due to damaged heart valves from rheumatic fever. Common manifestations of this condition are as outlined below:
- Cardiac symptoms – the person is likely to experienced difficulty breathing due to improper functioning of heart valve. Pain in the chest may be experienced, due to heart muscle strain or valve problems. Other symptoms include overall fatigue as a result of lesser cardiac output, and swelling due to fluid retention.
- Indications of improper functioning of heart valve – the person may observe or experience murmurs. These are unusual sounds in the heart due to flow of blood through damaged valves. Irregular heartbeats may also be experienced as a result of structural changes.
- Systemic symptoms – include pain in the joints, and could be experienced before other cardiac symptoms manifest. Outbreak of rashes or nodules may be visible beneath the skin.
- Long-term effects – there could be chronic complications like progressive heart valve disease. This is the result of aggravating heart failure and risk of stroke.
Tips To Avoid Complication Of Rheumatic Heart Disease?
To prevent complications of rheumatic heart disease, it is necessary to adopt an approach that is a combination of various measures. For instance, regular medical care, lifestyle modifications and importantly preventive care.
- Antibiotics – patients may be expected to continue antibiotics on a longer term as prophylaxis. This is to prevent future strep infections, that may be responsible for repeated episodes of rheumatic fever. This may be required for as long as 10 years.
- Follow-up – patients are expected to regularly visit the healthcare provider for follow-up. During follow-up care, actions would include going through an echocardiograms and clinical assessments to detect changes.
- Lifestyle – needs to be changed and this includes dietary changes, and regular exercise. A balanced diet with lesser saturated fats, sugars, and salt is important for heart health. Intake of fruits, vegetables, whole grains, and lean proteins are to be increased. Patients are to regularly exercise to improve cardiovascular health. Other actions include quitting smoking and avoiding alcohol.
- Existing conditions – are to be treated urgently. For instance, it is necessary to manage hypertension, diabetes, and other risk factors that are likely to cause complications of RHD.
What Are The Common Rheumatic Heart Disease Medication?
The management of rheumatic heart disease includes use of medications on a long term basis, apart from managing existing conditions. This is to alleviate symptoms, and prevent worsening of the condition.
- Antibiotics – one of the most important medications as prophylaxis for rheumatic fever is penicillin. Wherever necessary, alternate antibiotics such as erythromycin may be administered for patients allergic to penicillin
- Anti-inflammatory medicines – such as aspirin are commonly used during acute rheumatic fever. This is primarily to reduce inflammation and offer relief from pain. Additionally, corticosteroids may also be used when severe inflammation is experienced.
- Diuretics – help to reduce excessive fluid especially when heart failure symptoms manifest.
- Anticoagulants – such as warfarin or direct oral anticoagulants are mainly for patients at risk of thromboembolic events.
- Medicines for heart failure – include ACE inhibitors to reduce blood pressure and bring down the workload of the heart. Beta-blockers are also prescribed to control heart rate and improve heart function.
- Other medicines – include statins to manage cholesterol levels and to bring down possible cardiovascular risks.
The administration of medication depends on the patient’s condition and response. Management of the condition requires periodic monitoring and regulation of therapy, based on the response to the treatment. This will manage rheumatic heart disease effectively, while preventing future complications.
Related Blogs :
Shetty B s a cardiologist in Chennai, with extensive experience in the field. He completed his MBBS from Madurai Kamaraj University, followed by an MD in General Medicine and a DM in Cardiology from The Tamil Nadu Dr. M.G.R. Medical University (TNMGRMU).