Rheumatic fever and heart disease

Rheumatic fever is a serious condition that can lead to rheumatic heart disease. You can get rheumatic fever more than once. Learn what you can do to avoid getting rheumatic fever and protect your heart.

Rheumatic fever is a serious illness that can cause damage in your heart as well as swelling and pain in your elbows, wrists, knees, and ankles. You may also notice a skin rash, fever or jerky movements. Over time, most of these symptoms will go away but any damage to your heart may stay.

Rheumatic fever starts with a sore throat caused by Group A Streptococcal bugs (bacteria). If the ‘Strep throat’ isn’t treated, it can cause rheumatic fever, a delayed autoimmune reaction to the Streptococcal bugs. Rheumatic fever can damage your heart valves (rheumatic heart disease). 

Heart valves play an important role in making sure blood flows in one direction through the heart. When blood starts flowing backward, it can cause problems throughout your body.

Rheumatic fever most frequently affects Māori and Pacific young people between the ages of 4 – 19 years.

Get every sore throat checked

The best way to prevent rheumatic fever is to go and see your doctor when you get a sore throat. If you have a 'Strep throat' with infection from Strep bugs, the doctor will give you 10 days worth of antibiotics. It is really important to take these antibiotics for the full 10 days, even if you start feeling better sooner than that. Visit rheumaticfever.health.govt.nz to find out more about getting sore throats checked.

After having rheumatic fever, to help stop you from getting Strep throat and rheumatic fever again, you will need to have regular Penicillin (antibiotic) injections every 28 days. Penicillin kills the Strep bugs that trigger rheumatic fever, helping to stop any further damage to your heart valves.

After having rheumatic fever, any infection you have puts your heart at risk. You could develop a heart infection like endocarditis. You may need extra antibiotics to help protect your heart, particularly before you have any medical procedures or operations. This is why it is important to remember to tell every doctor, dentist or dental therapist that you have had rheumatic fever.

The symptoms of rheumatic fever usually start about one to five weeks after your child has been infected with the Strep bacteria. While each person may experience symptoms differently, the following are the most common symptoms of rheumatic fever:

  • Sore or swollen knees, elbows, ankles and/or wrists - including swelling, tenderness, and hotness over multiple joints. The inflammation 'moves' from one joint to another over several days.
  • Skin rash
  • Fever
  • Tiredness
  • Breathlessness
  • Fidgety, jerky movements.

Symptoms of rheumatic fever may resemble other medical conditions. If you think you or your child may have rheumatic fever, see your doctor immediately.

There is no one test to diagnose rheumatic fever. If your doctor suspects that you may have rheumatic fever, you will be sent to hospital. During your stay in hospital, you will have many tests, including blood tests and an echo scan (echocardiogram) to check on your heart. Blood tests are usually performed to assist in making a diagnosis. You may need to have a throat swab to find out if you have Streptococcus bacteria in your throat, although during the initial phase of rheumatic fever, the throat culture is often negative.

Rheumatic heart disease is usually diagnosed by your doctor hearing extra sounds called murmurs while they are listening to your heart. A murmur is the sound of blood flowing the wrong way through a leaky heart valve. 

Children with rheumatic fever are often treated in hospital, depending upon the severity of the disease. Sore joints are treated with rest and pain relief. You will be treated with Penicillin to get rid of the Strep bug and receive your first injection of Penicillin before leaving hospital. Depending on your symptoms and test results, you may need to stay resting in hospital for some weeks or months. People with badly damaged heart valves may need heart surgery.

The doctors will let you know how long you will need to rest when you go home. As soon as the doctor says it is safe for you to be active again, it is important to start exercising regularly and to lead a healthy lifestyle. With proper care and regular Penicillin injections, most people who have had rheumatic fever lead a normal life.

Read others experiences with rheumatic feverLearn more about heart valve problems