Heart and Blood Conditions

Rheumatic Heart Disease

What is rheumatic heart disease?

Rheumatic (pronounced roo-MAT-ik) heart disease is a condition in which the heart was damaged by rheumatic fever. Typically, this long-term damage occurs to the mitral valve, aortic valve or both. This damage may cause the valve to “leak” or become narrowed over time.

Usually, the symptoms of rheumatic heart disease show up 10 to 20 years after the original illness. The mitral valve (between the left atrium and left ventricle) is usually more affected than the aortic valve (between the left ventricle and aorta).

Rheumatic heart disease can be prevented by preventing rheumatic fever.

What is rheumatic fever?

Rheumatic fever is an inflammatory disease that sometimes happens after an infection caused by a bacteria called group A Streptococcus, like strep throat or scarlet fever. Rheumatic fever happens when the infection is not completely treated with medicine (antibiotics). It may affect the heart, joints, skin and brain.

Symptoms of rheumatic fever may include:

  • Fever
  • Joint swelling, tenderness, redness over multiple joints
  • Small bumps or nodules under the skin
  • Rash
  • Weight loss
  • Fatigue
  • Stomach pain

Rheumatic fever may cause serious, permanent damage to the valves of the heart. Most often, it damages the mitral valve, aortic valve or both. These valves act like doors in the heart that allow blood to pass between or out of the chambers on the left side of the heart. If the valves are damaged by rheumatic fever, they may not be able to open fully. This causes a narrowing of the valve (stenosis), or the valves may not be able to close fully, resulting in a “leak” or not enough blood supply.

Damage to the valves from rheumatic fever is known as valvulitis, meaning inflammation of the valve flaps (leaflets).

Rheumatic fever may also affect the heart muscle, a condition known as myocarditis (inflammation of the heart muscle), or the outer covering (membrane) of the heart, a condition known as pericarditis.

Rheumatic fever is the leading cause of valve disease that occurs after birth (acquired valve disease) in the world, but rheumatic fever is not very common in the United States.

Doctors can prevent rheumatic fever from happening by treating the strep throat with medicine (antibiotics).

Who is at risk for rheumatic fever?

Children ages 5 to 15 years are at risk for rheumatic fever, particularly if they have frequent strep throat infections. Rheumatic fever is also more common in children who have a family history of rheumatic heart disease or rheumatic fever. Fewer than 1 out of 300 people who have strep throat also get rheumatic fever.

Rheumatic Heart Disease at Seattle Children’s

We have extensive experience with the treatment of children and adolescents with rheumatic fever or rheumatic heart disease. We have a team of pediatric cardiac surgeons who are experienced in treating valves with stenosis or insufficiency. We also have a pediatric cardiac anesthesia team, cardiac intensive care unit and experts in pediatric infectious diseases ready to care for children with this condition.

When you come to Seattle Children’s, a team of people will take care of your child. Along with your child’s heart doctor (cardiologist), you are connected with a full range of pediatric subspecialists, nurses, child life specialists, social workers and others, if their help is needed. We work together to meet all of your child’s health needs and help your family through this experience.

Seattle Children’s has been treating children since 1907. Our team members are experts in their fields and in meeting the unique needs of children. For example, the doctors who give your child anesthesia (sedation) are board certified in pediatric anesthesiology. This means they have extra years of training in how to help kids deal with their medical conditions. Our child life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age.

Contact Us

Contact the Heart Center at 206-987-2015 for a cardiac referral, a second opinion or more information.