Rheumatic Heart Disease: Symptoms, Causes, and Diagnosis

Is rheumatic heart disease a serious condition?

Introduction

Four out of ten global patients with rheumatic heart disease are from India. The diseases accounts for more than 1,20,000 deaths annually. It is more prevalent in the less developed states of India, due to poor primary preventive care. Here is a detailed look at the disease and other similar heart disease conditions.

What is rheumatic heart disease and what are the symptoms?

This is a condition wherein heart valves are permanently damaged as a result of rheumatic fever. Untreated or poorly treated streptococcal infection causes damage to the heart valve. For instance, strep throat or scarlet fever if left untreated or if poorly treated may cause rheumatic heart disease.

Rheumatic fever is an inflammatory disease affecting connective tissues in the heart, joints, skin, or brain. When the heart valves are inflamed, with scarring, this causes a narrowing of the heart valve. As a result, it becomes harder for the heart to function. This condition develops over years gradually, and may ultimately result in heart failure.

Why are some people in India at higher risk of rheumatic heart disease?

Some people are at higher risk because of untreated or undertreated strep infections. For instance, children with repetitive strep throat infections are at higher risk.

Common symptoms of rheumatic heart disease

Difficulty breathing, especially during some physical activity or when resting.
Pain in the chest.
Abnormal swelling.

Diagnosis of rheumatic heart disease

Tests to diagnose rheumatic heart disease include:

Echocardiogram also known as echo.
Electrocardiogram – ECG/EKG.
Chest X-ray.
Cardiac MRI
Blood tests

What is cyanotic heart disease and what are the symptoms?

This refers to heart defects present at birth, causing reduction in oxygen levels. Cyanotic heart disease is also known as critical congenital heart disease or CCHD. Your body requires a steady supply of oxygen for normal functioning. This condition prevents the body from receiving the required oxygen.

There are three types of cyanotic heart disease:

Left heart obstructive lesions
Right heart obstructive lesions
Mixing lesions

Common symptoms of CCHD

Symptoms or indications of CCHD are typically visible in the first few weeks after birth, but are usually noticed at childhood. Common symptoms include:

Skin with bluish or purple appearance.
Fast paced breathing, and heart rate.
Build-up of fluid in the lungs.
During check-up, heart murmur is noticed.
Poor energy levels.
Low levels of oxygen.
Abnormally slow weight gain.
Difficulty breathing during activities

What is hypertensive heart disease and what are the symptoms?

This condition usually results from high blood pressure levels that have not been managed. This causes increased strain on the heart resulting in heart failure. Hypertensive heart disease develops over time causing one of many health issues. For instance, when blood pressure is higher than 120/80 mmHg for a long time, it causes hypertensive heart disease.

People with hypertensive heart disease are exposed to higher risk of heart failure, acute coronary syndrome and possible sudden cardiac death. Outcomes of hypertensive heart disease include coronary artery disease and enlarged heart.

Common symptoms of hypertensive heart disease.

Symptoms include the following, but are noticed only after the disease has progressed considerably.

Pain in the chest.
Difficulty breathing.
Changes in heart beat rate.
Dizzy feelings.
Possible stroke.

What is atherosclerotic heart disease and what are the symptoms?

This refers to hardening of the arteries as a result of plaque build-up in the arteries over a period of time. Plaque comprises fat, cholesterol and other substances, restricting blood flow. Atherosclerotic heart disease symptoms are typically not noticed initially and are experienced at a later date, when the complications start manifesting.

When the artery is blocked by more than half, symptoms maybe experienced in the body, depending on the location of the blockage. When the heart is affected, this may cause coronary artery disease. Symptoms include:

Difficulty breathing.
Pain in the chest, back, shoulders.
Dizziness.
Heart beat changes.
Overall tiredness.
Vomiting sensation.

Causes of atherosclerosis include the following:

High LDL cholesterol and triglyceride levels.
Uncontrolled high blood pressure.
Smoking
Diabetes

What is congenital acyanotic heart disease and what are the symptoms?

This is a heart defect affecting flow of blood. For instance, a hole in the heart wall may be present at birth but will cause problems at a later stage in life. Congenital acyanotic heart disease refers to abnormal heart structure at birth, and is of two types:

Cyanotic congenital heart disease – This involves heart defects that cause a reduction in the oxygen levels.
Acyanotic congenital heart disease – This involves heart defects, when the oxygen levels in the blood are enough, but are not pumped as desired.

Different types of acyanotic heart disease

Ther different kinds of acyanotic congenital heart defects include the following:

Aortic stenosis.
Atrial septal defect.
Atrioventricular septal defect.
Bicuspid aortic valve.
Coarctation of the aorta.
Patent ductus arteriosus.
Pulmonary stenosis.
Ventricular septal defect.

Common symptoms of acyanotic heart disease

Symptoms may be present at birth, but may not be noticed until issues begin to manifest. For instance, babies may have a heart murmur, if born with the condition. These birth defects cause high blood pressure, pulmonary hypertension, and can eventually end up with heart failure. Symptoms typically include:

Feelings of breathlessness.
Dizzy feelings.
Overall tiredness.

Causes of acyanotic heart disease and role of genetic testing

There is insufficient information about the reasons for congenital heart defects. However, studies suggest that this could be due to abnormal chromosomes or genetic reasons. Other issues such as sickness during pregnancy may also contribute to the causes. For instance, diabetes, blood disorders, drug abuse or viral infections may also be reasons.

Genetic testing has an important role in identifying, and mitigating the condition. Advanced genetic testing facilities in Tamil Nadu allow testing of blood or saliva sample to identify genetic components of disease. For instance, congenital defects at birth can be identified through genetic testing. Similarly, inherited conditions can also be identified through genetic testing. Based on the results, patients can seek advanced treatment to reduce the effects and future risk of complication

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Dr. Agarwal

Education: Bachelor of Pharmacy (B.Pharm) from the Tata Institute of Social Sciences (TISS), Mumbai Experience: Dr. Agarwal is a seasoned pharmacist with over 7 years of experience in the pharmaceutical field. She has worked in various settings, including hospital pharmacies and community clinics, where she has excelled in medication management, patient counseling, and clinical support. Dr. Agarwal is known for her expertise in drug therapy optimization and patient safety. In addition to her practical experience, she contributes to health journalism, focusing on pharmaceutical advancements and health policy, and is involved in research projects aimed at improving medication practices and health outcomes. is known for her expertise in drug therapy optimization and patient safety. In addition to her practical experience, she contributes to health journalism, focusing on pharmaceutical advancements and health policy, and is involved in research projects aimed at improving medication practices and health outcomes.