Rheumatic heart disease is the consequence of valvular harm impacted by an abnormal immune response to group A streptococcal infection, commonly during childhood. Rheumatic heart disease is the leading challenges in developing nations because poverty is one of the major leading cause of this disease. This disease can influence different organs in the body and lead to permanent valve damage and heart failure (Liu, Lu, Sun, Zheng, & Zhang, 2015). This report will explain the causes, symptoms, and diagnosis of rheumatic heart disease. Furthermore, this report considers the diagnosis, treatment, and prevention of rheumatic heart disease.
2.1 Causes and Risk factors
Rheumatic fever is the main cause of rheumatic heart disease which is generated by A streptococci infection in throat, heart, and lungs. Joints, central nervous system, and heart is the main parts which is affected by acute rheumatic heart disease. The rheumatic fever can cause fibrosis of heart valves which induce crippling valvular heart disease and heart failure or may lead to the death of the patient. Malnutrition, poverty, overcrowding, maternal educational level and unemployment are the known modifiable risk factors for acute rheumatic fever. The people who have recurrent episodes of rheumatic fever are at a higher risk of more attacks which can damage the heart.
The main symptom of rheumatic heart disease is rheumatic fever which directly leads to rheumatic heart disease if not treated properly in an initial phase. Other symptoms of this disease are migrating inflammation of large joints, carditis inflammation such as, myocarditis and pericarditis, Sydenham’s chorea which is series of rapid movements without purpose of the face and arm, Arthralgia, heart block, leukocytosis and recurrent episodes of rheumatic fever (Liu, Lu, Sun, Zheng, & Zhang, 2015).
This disease can be analyzed for the confirmation of Streptococcal infection, an expansion in antistreptolysin O titer or Deoxyribonuclease. The echocardiographic and Doppler examines have determined subclinical Carditis in patients with an acute rheumatic fever which proposed rheumatic heart disease in heart patients who had isolated cases of Sydenham chorea. Rheumatic heart disease also investigated by electrocardiogram and heart check up.
Acute throat infections generated by group A Streptococcus bacterium is an initial treatment to treat rheumatic fever. An oral antibiotic (usually Penicillin) up to 10 days or a single injection of Penicillin which helps to control the bacteria, streptococcus pyogenic infection. To treat acute rheumatic fever Corticosteroids and Aspirin are used as anti-inflammatory medications. At present, there is no cure for rheumatic heart disease. NIH, USA announced that rheumatic heart disease creates approximately 3 % of untreated Streptococcus throat infections (Liu, Lu, Sun, Zheng, & Zhang, 2015). The antibiotics are given for certain years to inhibit fever and heart disease in case of acute rheumatic heart disease. The open heart surgery is generally required to repair or replace heart valves in patients with severely impaired heart valves, the cost of which is very high and poor patients cannot manage the cost of treatment.
Prevention strategies are the most engaging choice for sustainable disease control in developing nations. Medical intervention is based on the elimination of group A streptococcus with penicillin, which prohibits the earliest acute rheumatic fever attack or disease frequency (Marijon, Mirabel, Celermajer, & Jouyen, 2012). Firstly, need to prevent from rheumatic fever because rheumatic fever is the considerable source of rheumatic heart disease. Vitamin C, vitamin E and natural antioxidants keep away from many heart diseases. The way of life changes, for example, no smoking, low salt, and sugar consume fewer calories, keeping up body weight and exercise additionally can prevent heart disease.
Rheumatic heart disease is the burden of developing countries which are directly associated with socioeconomic status, environmental risk factors and education. Overcrowding and unemployment directly increased the risk of rheumatic heart disease (Okello et al. 2012). Treatment is very costly such as cardiac valve repair and replacement and as well as antibiotics. Due to expensive treatment people would not able to treat properly so death occurs so the mortality rate as a result of rheumatic heart disease is very high. About 30 million children and young adults in underdeveloped countries go through this heart disease. Health-care access, housing and health literacy other aspects are prone to be responsible for these striking contrasts (Milne et al., 2012).
Rheumatic fever, streptococci infection in lung, heart and throat is the main cause of rheumatic heart disease which is the major problem of developing countries. Unemployment, malnutrition and lack of proper education also lead to rheumatic heart disease. Recurrent rheumatic fever, inflammation of large joints and throat infection is the symptoms of rheumatic heart disease. Corticosteroids and Aspirin are used as anti-inflammatory medicines to prevent from rheumatic fever. The antibiotics (penicillin) is used as a treatment to restraint the bacteria, Streptococcus pyogenic infection. Valve repair and valve replacement surgery are also the treatment of rheumatic heart disease.
The government should aware about early treatment of underlying and insignificant treatment of streptococcal throat infection. In addition, new housing design need to set up to prevent from the overcrowded housing. In addition, mobile rheumatic heart disease screening facilities ought to be set up in schools and communities time to time where health facilities are far from the population. Valve repair and replacement should be free so the poor patients also can do surgery because this surgery is expensive so cannot afford it. Need to focus on the treatment of throat infection and rheumatic fever in an initial stage. The government should provide proper education, an awareness program and employment to the which helps to maintain the socioeconomic status of the public.