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What is rheumatic heart disease?

Rheumatic heart disease (RHD) is a disorder of the heart in which irreversible valve damage and heart failure, along with, organ damage is seen following a streptococcal throat infection. Acute rheumatic fever (ARF) is the precursor of this disease.

What are its main signs and symptoms?

Sometimes RHD can occur without any symptoms and symptoms, if present, may include:

  • When damaged heart valves are infected, fever is an associated symptom.
  • Swelling (oedema).
  • Problems with breathing in lying down position (orthopnoea) and/or breathlessness on exertion.
  • Pain in the chest or heart palpitations.
  • Arousal from sleep feeling the need to sit or stand up (paroxysmal nocturnal dyspnoea).
  • Fainting (syncope).
  • Heart murmur.
  • Stroke.

What are the main causes?

The main cause of RHD is group A streptococci infection, which causes an abnormal autoimmune response in a host who is genetically susceptible. This exaggerated reaction leads to inflammation across multiple tissues in the body.

How is it diagnosed and treated?

The physician will take a detailed history of the symptoms and medical history (evidence of past ARF or streptococcal infection) along with a thorough physical examination. Sometimes, a heart murmur is encountered during this examination, which may suggest RHD. However, in some patients with RHD, a heart murmur may not be heard. The physician might also suggest the following tests:

  • Chest X-ray – For checking heart enlargement or presence of fluid in the lungs.
  • Electrocardiogram (ECG) – For checking heart chambers enlargement or abnormality in the heart rhythm (arrhythmia).
  • Echocardiogram – For checking the heart valves (for damage, infection).

Management of RHD varies as per the severity of the disease and includes:

  • In cases of heart failure, hospital admission is necessary for treatment.
  • For infections, generally seen in the heart valves, antibiotics (mainly penicillin) are also prescribed.
  • For prevention of stroke or when thinning blood is required for replacement of valves, blood-thinning medicines are prescribed.
  • To open up stuck valves, balloon surgery is required where a balloon is inserted through a vein.
  • For repairing or replacing damaged heart valves, heart valve surgery may be required.
  1. Medicines for Rheumatic Heart Disease

Medicines for Rheumatic Heart Disease

Medicines listed below are available for Rheumatic Heart Disease. Please note that you should not take any medicines without doctor consultation. Taking any medicine without doctor's consultation can cause serious problems.

Medicine NamePack SizePrice (Rs.)
WysoloneWYSOLONE 20MG TABLET33
Gatiquin PGATIQUIN P EYE DROP 5ML90
PredzyPredzy 3 Mg/10 Mg Eye Drops52
Gatsun PGatsun P 0.3%/1% Drops9
Siogat PSiogat P 0.3%/1% Eye Drops44
Zengat PZengat P Eye Drops10
Z PredZ Pred 0.3%/1% Eye Drops40
Gate PdGate Pd 3 Mg/10 Mg Eye Drops20
Gate P PGate P P 3 Mg/10 Mg Eye Drops26
4 Quin Pd4 Quin Pd 0.5% W/V/1% W/V Eye Drop60
Apdrops PdAPDROPS PD EYE DROPS 5ML0
CombaceCombace 0.5%/1% Eye Drops9
EmsoloneEmsolone 10 Mg Tablet0
Mo 4 PdMO 4 PD EYE DROPS 10ML72
KidpredKidpred Syrup20
MethpredMethpred 125 Mg Injection200
MoxipredMoxipred Eye Drops11
OmnacortilOMNACORTIL -40MG TABLET23
Omnacortil ForteOMNACORTIL FORTE SYRUP 60ML39
Moxigram PMoxigram P Eye Drop10
Prednisolone Acetate (Alcon Lab)Prednisolone Acetate 1% Drop52
Occumox POccumox P Eye Drop0
Prednisolone Acetate (Aller)Prednisolone Acetate 10 Mg Suspension52
PredonePredone 1% Eye Drop0

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References

  1. Better health channel. Department of Health and Human Services [internet]. State government of Victoria; Rheumatic heart disease.
  2. Liu M et al. Rheumatic Heart Disease: Causes, Symptoms, and Treatments.. Cell Biochem Biophys. 2015 Jul;72(3):861-3. PMID: 25638346
  3. National Health Portal [Internet] India; Rheumatic fever and rheumatic heart disease.
  4. Sika-Paotonu D, Beaton A, Raghu A, et al. Acute Rheumatic Fever and Rheumatic Heart Disease. 2017 Mar 10 [Updated 2017 Apr 3]. In: Ferretti JJ, Stevens DL, Fischetti VA, editors. Streptococcus pyogenes : Basic Biology to Clinical Manifestations [Internet]. Oklahoma City (OK): University of Oklahom
  5. Harris C,Croce B,Cao C. Rheumatic heart disease. Ann Cardiothorac Surg. 2015 Sep;4(5):492. PMID: 26539360

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