Rheumatic heart disease is permanent damage to the heart following an episode (or recurrent episodes) of acute rheumatic fever.SkiptomaincontentWhatisrheumaticheartdisease?FactCheckedWrittenby SaraNoonanRheumaticheartdisease(RHD)isaseriousdiseaseoftheheartinvolvingdamagetooneormoreofthefoursmallheartvalves.Thevalvedamageremainsafteranillnesscalled acuterheumaticfever(ARF).DuringARFtheheartvalvetissue,andsometimesotherpartsoftheheart(theheartliningormuscle)canbecomeswollen,andthisiscalledcarditis.Followingcarditis,theheartvalvescanremaindamagedthenbecomescarred,andtheresultisaninterruptiontonormalbloodflowthroughthedamagedvalves.Somebloodmayflowbackwardthroughaleakyvalvethatdoesnotcloseproperly,orbloodmaybeblockedbecauseatight,scarredvalvedoesnotopenproperly.Whentheheartisdamagedinthisway,theheartvalveisnotabletofunctionadequately,andheartsurgerymayberequiredtorepairorreplacethedamagedvalve.RegularantibioticsareprescribedforpeoplewithRHDtopreventrecurrentARFandsubsequentworseningofthevalvedamage.1Rheumaticheartdiseaseisachronic,disablingandsometimesfataldiseasethatisentirely preventable.Whatarethesymptomsofrheumaticheartdisease?RHDisdiagnosedbyechocardiogram(ultrasound).2SymptomsofmildRHDmaynotbenoticedformanyyears.3Whentheydodevelop,symptomsusuallydependonwhichheartvalvesareaffected,andthetypeandseverityofthedamage.ManypeoplewithRHDhaveaheartmurmur,whichcanbeheardthroughastethoscope.Symptomsofmoreseverediseasecanincludechestpain,breathlessnesswithphysicalactivityorwhenlyingdown,weaknessandtiredness,andswellingofthelegs.MorethanhalfofthosewithARFprogresstoRHDwithin10yearsoftheirinitialARFepisode,andmorethanone-thirdofthesepeopledevelopsevereRHD.4 WithsevereRHDthereisariskofabnormalheartrhythms,stroke,endocarditis,andcomplicationsduringpregnancy.5 Thesecomplicationscauseprogressivedisability,reducequalityoflife,andcanleadtoprematuredeathinyoungadults.Heartsurgerycanmanagesomeoftheseproblemsandprolonglife,butdoesnotcureRHD.Closemonitoringwithregularechocardiographycanh