Rheumatic Heart Disease is a type of cardiovascular disease in which heart valves get damaged.

1. Rheumatic Heart
Disease

2. Symptoms & Diagnosis
Treatment & IncidenceEtiopathogenesis
Introduction
Rheumatic Heart Disease
Rheumatic Fever
The signs and diagnosis of
Rheumatic Heart Disease
Treatment of RHD and its
occurance
Etiology and pathogenesis of
Rheumatic Heart Disease
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3. Rheumatic heart diseases is a condition in
which the heart valves get permanently
damaged by Rheumatic fever.
An immune response causes an
inflammatory condition in the body
resulting in ongoing valve damage.
INTRODUCTION

4. What is Rheumatic fever?
Rheumatic fever is an
inflammatory disease that can
develop when strep throat or
scarlet fever isn't properly treated.
Strep throat and scarlet fever
are caused by an infection
with streptococcus bacteria.
Rheumatic fever causes the
body to attack its own tissues.
This reaction causes
widespread inflammation
throughout the body, which is
the basis for all symptoms of
rheumatic fever.

5. The etiology and pathogenesis of Rf and RHD has three factors : Environmental Factors, Host susceptibility and
immunological evidences.
A. ENVIRONMENTAL FACTORS:
● Subsequent attacks of streptococcal infection are associated with recurrent episodes of Rheumatic Fever.
● A history of throat infection before Rheumatic fever is often noticed.
● Socioeconomic factors like poverty, poor nutrition, density of population are associated with spread of infection.
● The role of climate in the development of Rheumatic Fever has also been reported.
B. HOST SUSCEPTIBILITY:
Role of inherited characteristics in the development of RF has been reported:
● Clustering disease in families
● Occurance in identical twins
● First-degree relatives of patients with RF and RHd have increased expression of a particular alloantigen, acting
as a marker for inherited susceptibility for the disease.
ETIOPATHOGENESIS

6. C. IMMUNOLOGICAL EVIDENCE:
● Patients with RF have elevated titres of antibodies to the antigens of Beta haemolytic streptococci of group A.
● Cell wall polysaccharides of group A Streptococcus forms antibodies which are reactive to heart valves
● Hyaluronate capsule of group A streptococcus is identical to human hyaluronate present in human joint tissues
and thus tissues are the target of attack.
● Membrane antigens of group A streptococcus react with sarcolemma of smooth and cardiac muscle and dermal
fibroblasts.
Combining the above evidences, pathogenesis of Rf-RHD can be summed up into following steps:
1. A susceptible host, on being encountered with group A Streptococcus infection, mounts an autoimmune reaction
by formation of antibodies against bacteria.
2. These autoantibodies cause damage to human tissues due to cross reactivity between epitopes in components
of bacteria and host.
3. Streptococcal epitopes present on the bacterial cell wall, cell membrane and streptococcal M protein are
immunologically identical to human molecules.
4. Molecular mimicry and cross reactivity forms the basis of autoimmune damage to human target tissues in RHD
i.e cardiac muscles ,valves ,etc.

7. Symptoms

8. ● Shortness of breath
(especially with activity or
when lying down)
● Chest pain
● Swelling
● Nodules (lumps under the
skin)
● Red, raised, lattice-like rash,
usually on the chest, back,
and abdomen
● Uncontrolled movements of
arms, legs, or facial muscles
● Weakness

9. Diagnosis
● Echocardiogram
● Electrocardiogram
● Chest X-ray
● Cardiac MRI
● Blood tests
People with rheumatic heart disease
will have or recently had a strep
infection. A throat culture or blood test
may be used to check for strep.Other
tests are also used to diagnose
rheumatic heart disease, they may
include:

10. Treatment
Antibiotic therapy has sharply reduced the
incidence and mortality rate of rheumatic
fever/rheumatic heart disease.
To reduce inflammation, aspirin, steroids,
or non-steroidal medications may be
given.
Surgery may be necessary to repair or
replace the damaged valve.

11. Incidence

12. The largest number of
deaths occurred in East Asia
and South Asia.
In 2015, India estimated the
highest number of cases.
The highest age-standardized
death rates occurred in
Oceania, South Asia, and
central sub-Saharan Africa

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