Medical Insider – Dr. Ria P. Maslog
Rheumatic Heart Disease
The most serious complication of acute rheumatic fever is rheumatic heart disease. This may occur as a result of frequent and recurrent attacks of carditis or severe pancarditis.
In this case, the mitral valve is affected three times more than the aortic valve. The tricuspid and the pulmonic valves are less frequently involved.
Mitral regurgitation is the most common valvular involvement in children with rheumatic heart disease. This is more common in males than in females. Clinically, children may be asymptomatic during childhood but occasionally may have easy fatigue and palpitation.
In about 50% of cases, mitral stenosis may develop after at least one or two years. Other concomittant problems that may co exist are infective endocarditis and left ventricular failure.
Mitral stenosis is the most common valvular involvement in adult rheumatic patients. However, this condition has been observed among the 8 to 10 years old.
Affected individuals, may complain of dyspnea, palpitation and easy fatigability. Complications such as atrial fibrillation , thromboembolism, infective endocarditis and severe pulmonary hypertension may arise.
Aortic regurgitation usually has an associated mitral valve disease, either in the form of mitral insufficiency, or mitral stenosis.
Like the mitral regurgitation and stenosis, patients may remain asymptomatic for a long time. Severe anginal pain may be present because of insufficient filling of the coronaries during diastole.
Aortic regurgitation with concomitant premature ventricular contractions in angina may indicate a poor prognosis.