Home > Your Health > Medical Procedures > Aortic valve replacement > Rheumatic Fever

Rheumatic Fever by Editorial Staff and Contributors

Definition

Rheumatic fever is an inflammatory condition. It involves the connective tissue in the body. The most severe complication is rheumatic heart disease. This condition may permanently damage the heart valves. Valves affects the flow of blood to and from the heart. Symptoms of valve damage often don't appear for 10-30 years after the initial event.

Diseased Heart Valve

Causes

Rheumatic fever is caused by a problem in the immune system. It happens in response to group A Streptococcus pharyngitis ( strep throat ). In this case, the immune system not only fights the bacteria but also attacks its own tissue. It often attacks heart tissue.

Risk Factors

Factors that may increase your risk of rheumatic fever include:

Age: 5 to 15 years old
Previous case of rheumatic fever
Malnutrition
Overcrowded living conditions

Symptoms

Symptoms usually appear 2 to 4 weeks after a strep infection. They may include:

Pain and swelling in large joints
Fever
Weakness
Muscle aches
Shortness of breath
Chest pain
Nausea and vomiting
Hacking cough
Circular rash
Lumps under the skin
Abnormal, sudden movements of arms and legs

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. This will include a careful exam of your heart. The doctor may take a throat culture. A blood test for streptococcal antibodies may be done.

Other tests may include:

Other blood tests—such as erythrocyte sedimentation rate to measure inflammation in the body, and blood cultures for bacteria in the blood
Electrocardiogram —a test that records the heart's activity by measuring electrical currents through the heart muscle
Echocardiogram —a sonogram which visualizes the heart valves, and measures the contractile function of the heart muscle
Chest x-rays —a test that uses radiation to take a picture of structures inside the body, in this case the heart

Treatment

The goals of treatment are to:

Kill the strep bacteria
Treat the inflammation caused by the rheumatic fever
Prevent future cases of rheumatic fever

Treatment may include:

Medication

To treat the strep infection:

Penicillin or other antibiotics (eg, erythromycin and azithromycin )
Antibiotics may need to be taken for several years to prevent recurrence
May be given by mouth or injection

To help with joint pain and swelling:

Aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs)
Corticosteroids may be used if NSAIDs are not effective

Rest

In some cases the inflammation can be severe. You may have to be on bed rest or restricted activity for a period of time.

Prevention

It is important to treat strep throat with antibiotics promptly. This will help to prevent rheumatic fever. If you or your child has a sore throat and a fever that lasts more than 24 hours, contact your doctor.

RESOURCES:

American Heart Association http://www.americanheart.org/
National Library of Medicine http://www.nlm.nih.gov/

CANADIAN RESOURCES:

Health Canada http://www.hc-sc.gc.ca/
Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca/

References:

American Heart Association website. Available at: http://www.americanheart.org .
Mayo Clinic and Foundation for Medical Education and Research website. Available at: http://www.mayo.edu/ .
The Merck Manual of Medical Information—Home Edition . Merck Research Laboratories; 1999.
Nausieda PA, Grossman BJ, Koller WC: Sydenham chorea: an update. Neurology . 1980;30:331-334.
Robertson KA, Volmink JA, Mayosi BM. Antibiotics for the primary prevention of acute rheumatic fever. BMC Cardiovasc Disorders . 2005; 5:11.
Spagnuolo M, Pasternack B, Taranta A. Risk of rheumatic fever recurrences after streptococcal infections: prospective study of clinical and social factors. N Engl J Med . 1971;285:641-647.
University of Michigan Medical Center website. Available at: http://www.med.umich.edu/ .

Last reviewed Feburary 2010 by Marcin Chwistek, MD

All EBSCO Publishing proprietary, consumer health and medical information found on this site is accredited by URAC. URAC's Health Web Site Accreditation Program requires compliance with 53 rigorous standards of quality and accountability, verified by independent audits. To send comments or feedback to our Editorial Team regarding the content please email us at HLEditorialTeam@ebscohost.com.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.