Overview
Rheumatic heart disease (RHD) is a long-term complication of rheumatic fever that causes permanent damage to the heart valves. It occurs when rheumatic fever, an inflammatory condition triggered by untreated strep throat or scarlet fever, affects the heart. RHD can lead to serious heart problems, including heart failure, arrhythmias, and stroke, making early prevention and management critical.
What is Rheumatic Heart Disease?
Rheumatic heart disease develops when inflammation from rheumatic fever damages the heart valves, especially the mitral and aortic valves. This damage can cause the valves to become narrowed (stenosis) or leaky (regurgitation), disrupting normal blood flow through the heart. The condition can develop years after the initial rheumatic fever episode and may progress silently until significant heart damage occurs.
Symptoms
Symptoms of rheumatic heart disease vary depending on the severity of valve damage and may include
- Shortness of breath during activity or when lying down
- Fatigue and weakness
- Swelling in the legs, ankles, or abdomen
- Chest pain or discomfort
- Heart palpitations or irregular heartbeat
- Fainting or dizziness
- Recurrent fever and joint pain if rheumatic fever recurs
Causes
Rheumatic heart disease is caused by damage from rheumatic fever, which itself results from an abnormal immune reaction to Group A Streptococcus bacteria. The body’s immune system mistakenly attacks healthy heart tissue, leading to scarring and deformation of the valves.
Risk Factors
Risk factors for rheumatic heart disease include
- History of rheumatic fever
- Repeated or untreated strep throat infections
- Living in areas with limited access to antibiotics and healthcare
- Overcrowded or unsanitary living conditions
- Family history of rheumatic fever or RHD
Complications
If untreated, rheumatic heart disease can lead to
- Heart failure due to valve dysfunction
- Atrial fibrillation or other arrhythmias
- Stroke caused by blood clots forming in the heart
- Infective endocarditis (infection of damaged valves)
- Sudden cardiac death in severe cases
Prevention
Prevention strategies include
- Prompt and complete treatment of strep throat or scarlet fever with antibiotics
- Long-term preventive antibiotics in people with a history of rheumatic fever to avoid recurrence
- Regular heart check-ups for early detection of valve problems
- Good hygiene and avoidance of contact with individuals who have untreated strep infections
Treatment Options in Korea
South Korea offers advanced diagnostics, minimally invasive heart procedures, and comprehensive care for rheumatic heart disease.
1. Medical Management – Medications such as diuretics, beta-blockers, ACE inhibitors, and anticoagulants are used to control symptoms, reduce fluid buildup, and prevent blood clots.
2. Antibiotic Prophylaxis – Long-term antibiotics are prescribed to prevent recurring rheumatic fever and further valve damage.
3. Surgical Valve Repair or Replacement – In severe cases, Korean cardiac surgeons perform valve repair or replacement using mechanical or bioprosthetic valves, often with minimally invasive techniques.
4. Percutaneous Balloon Valvotomy – A catheter-based procedure used to widen narrowed valves without open-heart surgery.
5. Cardiac Rehabilitation – Specialized rehabilitation programs help patients recover after surgery and maintain heart health through exercise, diet, and lifestyle changes.
6. Leading Korean Hospitals for Rheumatic Heart Disease Treatment
- Asan Medical Center – Heart Institute
- Seoul National University Hospital – Cardiac Surgery & Cardiology Departments
- Samsung Medical Center – Cardiovascular Center
- Severance Hospital – Valve Repair & Replacement Unit
