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 affects the flow of blood to and from the heart. Symptoms of valve damage often don't appear for 10-30 years after the initial event.
Diseased Heart Valve
Rheumatic fever is caused by a problem in the immune system. It happens in response to group A Streptococcus pharyngitis ( strep throat]]> ). In this case, the immune system not only fights the bacteria but also attacks its own tissue. It often attacks heart tissue.
Factors that may increase your risk of rheumatic fever include:
- Age: 5 to 15 years old
- Previous case of rheumatic fever
- Overcrowded living conditions
Symptoms usually appear 2 to 4 weeks after a strep infection. They may include:
- Pain and swelling in large joints
- 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
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. The doctor may take a throat culture. A blood test for streptococcal antibodies may be done.
Other tests may include:
- Other blood tests—such as erythrocyte sedimentation rate to measure inflammation in the body, and blood cultures for bacteria in the blood
- Electrocardiogram]]> —a test that records the heart's activity by measuring electrical currents through the heart muscle
- ]]>Echocardiogram]]> —a sonogram which visualizes the heart valves, and measures the contractile function of the heart muscle
- ]]>Chest x-rays]]> —a test that uses radiation to take a picture of structures inside the body, in this case the heart
The goals of treatment are to:
- Kill the strep bacteria
- Treat the inflammation caused by the rheumatic fever
- Prevent future cases of rheumatic fever
Treatment may include:
To treat the strep infection:
- Penicillin or other antibiotics (eg, erythromycin]]> and ]]>azithromycin]]> )
- Antibiotics may need to be taken for several years to prevent recurrence
- May be given by mouth or injection
To help with joint pain and swelling:
- ]]>Aspirin]]> or other nonsteroidal anti-inflammatory drugs (NSAIDs)
- Corticosteroids may be used if NSAIDs are not effective
In some cases the inflammation can be severe. You may have to be on bed rest or restricted activity for a period of time.
It is important to treat strep throat with antibiotics promptly. This will help to prevent rheumatic fever. If you or your child has a sore throat]]> and a fever that lasts more than 24 hours, contact your doctor.
American Heart Association
National Library of Medicine
Heart and Stroke Foundation of Canada
American Heart Association website. Available at: http://www.americanheart.org .
Mayo Clinic and Foundation for Medical Education and Research website. Available at: http://www.mayo.edu/ .
The Merck Manual of Medical Information—Home Edition . Merck Research Laboratories; 1999.
Nausieda PA, Grossman BJ, Koller WC: Sydenham chorea: an update. Neurology . 1980;30:331-334.
Robertson KA, Volmink JA, Mayosi BM. Antibiotics for the primary prevention of acute rheumatic fever. BMC Cardiovasc Disorders . 2005; 5:11.
Spagnuolo M, Pasternack B, Taranta A. Risk of rheumatic fever recurrences after streptococcal infections: prospective study of clinical and social factors. N Engl J Med . 1971;285:641-647.
University of Michigan Medical Center website. Available at: http://www.med.umich.edu/ .
Last reviewed January 2009 by ]]>Jill D. Landis, 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.
Copyright © 2007 EBSCO Publishing All rights reserved.