rheumatic heart disease

Rheumatic heart disease is an acquired condition that affects the heart, specifically its lining, muscle, and the sac surrounding it. It develops as a consequence of acute rheumatic fever, an infection caused by Streptococcus pyogenes organisms. This inflammation can lead to lasting damage, particularly to the heart valves, which may eventually result in heart failure.1

The exact cause of rheumatic fever is not fully understood, but it typically occurs days or weeks after the initial streptococcal infection. Immunologic responses to foreign proteins are believed to play a role in the damage to the heart and its valves. While the incidence of rheumatic fever and rheumatic heart disease has declined with better control of streptococcal infections, the primary pathological lesion involves inflammatory changes in collagen, the main supportive protein of connective tissue. This can lead to valve deformities, such as stenosis (narrowing) or insufficiency (leakage), most commonly affecting the mitral and aortic valves.1