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Definition

Rheumatic fever is an inflammatory condition. It involves the connective tissue in the body. The most severe complication is rheumatic heart disease. This condition may permanently damage the heart valves. Valves control the flow of blood to and from the heart.

Diseased Heart Valve

Diseased Aortic Valve

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Causes

Rheumatic fever is caused by group A Streptococcus pharyngitis, also known as strep throat. In this case, the body uses antibodies to fight the infection, but the antibodies also attack the heart.

Risk Factors

Rheumatic fever is more common in children and adolescents aged 5-15 years. Other factors that may increase your chance of rheumatic fever include:

  • Having strep throat
  • Prior case of rheumatic fever
Symptoms

Symptoms usually appear 2 to 4 weeks after a strep infection. They may include:

  • Pain and swelling in large joints
  • Fever
  • Weakness
  • Muscle aches
  • Shortness of breath
  • Chest pain
  • Nausea and vomiting
  • Hacking cough
  • Circular rash
  • Lumps under the skin
  • Abnormal, sudden movements of arms and legs
Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. This will include a careful exam of your heart.

Other tests may include:

  • Samples may be taken of your bodily fluids and tissues. This can be done with:
    • Blood tests
    • Throat culture
  • You may need to have pictures taken of your heart. This can be done with:
  • You may need to have your heart activity measured. This can be done with an electrocardiogram (EKG) .
Treatment

The goals of treatment are to:

  • Kill the strep bacteria
  • Treat the inflammation caused by the rheumatic fever
  • Treat any cardiac problems
  • Prevent future cases of rheumatic fever
Medication

To treat the strep infection:

  • Antibiotics
  • May be given by mouth or injection

To help with joint pain and swelling:

  • Aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs)—only if advised by your doctor
  • Corticosteroids may be used if NSAIDs are not effective or if there is inflammation of the heart
Rest

In some cases, the inflammation can be severe. You may have to rest for a period of time.

Prevention

It is important to treat strep throat with antibiotics right away. This will help prevent rheumatic fever. If you or your child has a sore throat and a fever that lasts more than 24 hours, contact your doctor.

RESOURCES:

American Heart Association
http://www.heart.org

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca

Heart and Stroke Foundation of Canada
http://www.heartandstroke.com

References:

Acute rheumatic fever. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 7, 2014. Accessed September 26, 2014.

Nausieda PA, Grossman BJ, et al.: Sydenham chorea: an update. Neurology. 1980;30:331-334.

Rheumatic fever. Texas Heart Institute website. Available at: http://www.texasheartinstitute.org/HIC/Topics/cond/rheufev.cfm. Updated August 2014. Accessed September 26, 2014.

Robertson KA, Volmink JA, et al. Antibiotics for the primary prevention of acute rheumatic fever. BMC Cardiovasc Disorders. 2005; 5:11.

Spagnuolo M, Pasternack B, et al. Risk of rheumatic fever recurrences after streptococcal infections: prospective study of clinical and social factors. N Engl J Med. 1971;285:641-647.



Last reviewed August 2014 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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