rheumatic heart disease

Rheumatic heart disease is the lasting scar left on the heart valves by an immune reaction gone wrong. After a throat infection with a particular type of streptococcal bacteria, the body's defenses can mistakenly attack its own tissues, including the heart — an illness called rheumatic fever. Even after the fever resolves, repeated or severe attacks can permanently damage the valves.

The mitral valve is affected most often, with the aortic valve next; the leaflets thicken, fuse, and scar over years. This typically produces mitral stenosis, regurgitation, or a mix of both, with symptoms such as breathlessness, fatigue, palpitations from atrial fibrillation, and the complications of a strained, enlarged left atrium.

Once common everywhere, rheumatic heart disease has become rare in high-income countries but remains a major cause of valve disease and premature death in many lower-income regions, often striking children and young adults. Prevention hinges on promptly treating streptococcal throat infections and on long-term antibiotic prophylaxis to prevent recurrent rheumatic fever in those already affected.

Rheumatic valve disease is a chronic condition needing lifelong follow-up; this entry explains the disease in general terms only.