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Pathology of Rheumatic Valvular Disease

The American Heart Association (AHA) says rheumatic heart disease occurs when the heart valves are harmed by rheumatic fever. This condition may also be referred to as rheumatic valvular disease. Rheumatic fever is one of several conditions that can lead to valvular damage. It is an inflammatory condition that typically begins with a strep (strep pharyngitis) throat. The job of the heart's valves is to regulate blood flow through the heart. Over time, valve disease can cause the heart muscle to become overburdened and treatment is required to prevent further damage.

  1. Rheumatic Fever

    • While the number of rheumatic fever/rheumatic heart disease cases in the U.S. is low, the AHA says it remains a primary cause of cardiovascular death during the first 50 years of life.

      Rheumatic fever can strike anyone but most frequently occurs in children between 5 and 15 years of age. The potentially subsequent rheumatic heart disease can last a lifetime, negatively impacting a number of the body's connective tissues, particularly those of the skin, brain, joints and heart.

      Rheumatic fever can damage the aortic heart valve by preventing it from closing securely.

    Aortic Valve Damage

    • When a heart valve is dysfunctional it fails to either open or close correctly. When it refuses to close tightly, blood can leak backward creating what's referred to as regurgitation. When the aortic valve is harmed by rheumatic fever, it can eventually lead to aortic valve regurgitation.

    Symptoms

    • The symptoms associated with aortic valve regurgitation usually develop slowly over a period of time, possibly years.

      The Mayo Clinic says the symptoms may include fatigue, weakness and shortness of breath especially with exertion.

      You may experience chest pain, a rapid or irregular heartbeat, heart palpitations (fluttering heart) and swollen feet and ankles.

    Treatment

    • Treatment of aortic valve regurgitation depends on the severity of your regurgitation and whether it's impairing the functioning of your heart. Your doctor will regularly monitor your heart with echocardiograms to learn whether your heart's performance is declining.

    Surgery

    • Aortic valve repair is surgery, which is performed to improve the function of the narrowed valve. In some instances, surgeons can adjust the valve (valvuloplasty) to stop backward blood flow.

      The aortic valve is sometimes replaced with a mechanical valve to resolve aortic valve regurgitation. Mechanical valves are constructed with durable metal but they pose a risk of blood clots developing on or near the valve.

      In general, the prognosis following surgery is very good.

    Prevention

    • When the initial strep throat is treated with antibiotics such as penicillin, acute rheumatic fever can frequently be thwarted and as a result rheumatic heart disease can be prevented.

      Former rheumatic fever patients are more likely to suffer from future attacks and heart damage.They are often prescribed long-term antibiotic--sometimes for life--to ward off a recurrence.

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