Rheumatic Heart Disease in Children
What is rheumatic heart disease in children?
Rheumatic heart disease is a condition that causes permanent damage to the heart valves.
It can develop after a child has rheumatic fever. Rheumatic fever is the body's response
to a strep infection of the throat or tonsils, known as "strep throat." Rheumatic
fever may also follow scarlet fever. This is a strep infection of the throat along
with a red, rough-feeling skin rash. Rheumatic fever may affect the joints, skin,
tissue under the skin, brain, and heart. If it affects the heart, it is called rheumatic
What causes rheumatic heart disease in a child?
Rheumatic heart disease is caused by rheumatic fever. Rheumatic fever is a complication
of an untreated or under-treated strep infection.
Which children are at risk for rheumatic heart disease?
Rheumatic heart disease is uncommon in the U.S. because rheumatic fever is also not
common. Rheumatic fever occurs more often in children between ages 5 and 15. This
is more of a risk if they have had frequent cases of strep throat. Poor access to
medical care is a risk factor for rheumatic heart disease as strep infections are
more likely to be missed and go untreated.
What are the symptoms of rheumatic heart disease in a child?
Your child may have signs and symptoms due to the heart not working as well, such
Your child may also have other signs and symptoms of rheumatic fever. These include:
Joint pain and swelling
Small, hard, round bumps under the skin (nodules)
Irregular or jerky movements
Belly (abdominal) pain
Lightheadedness or dizziness
The symptoms of rheumatic heart disease can be like other health conditions. Make
sure your child sees their healthcare provider for a diagnosis.
How is rheumatic heart disease diagnosed in a child?
The healthcare provider will ask about your child’s symptoms and health history, including
having rheumatic fever or strep infections. They will give your child a physical exam.
Your child may also have tests, such as:
Throat culture. This is a test to see if your child has strep throat or signs of a recent strep infection.
Echocardiography.This is an imaging test that uses sound waves (ultrasound) to make detailed pictures
of the heart.
Electrocardiography. This is a test to measure the electrical activity of the heart.
Blood tests. For these, a small amount of blood is taken with a needle from a vein in an arm or
How is rheumatic heart disease treated in a child?
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is. Your child's healthcare provider will likely
refer you to a pediatric cardiologist. This is a doctor with special training to treat
heart problems in children. Your child may also see other specialists, depending on
Children with rheumatic heart disease will need to rest until their symptoms get better.
Your child’s healthcare provider may prescribe 1 or more of these medicines:
Antibiotics to treat the acute strep infection
Long-term antibiotics to prevent recurrent strep infection
Steroids or nonsteroidal anti-inflammatory drugs (NSAIDs) to ease inflammation in
the heart and in other parts of the body
Water pills (diuretics) if heart failure develops
Anti-inflammatory medicine for the management of fever and arthritis symptoms
Your child may also need other medicines. Some children need surgery to fix or replace
damaged heart valves.
What are possible complications of rheumatic heart disease in a child?
Possible complications of rheumatic heart disease include:
What can I do to prevent rheumatic heart disease in my child?
You can help prevent rheumatic fever and rheumatic heart disease by knowing what strep
throat looks like and getting treatment for it. Your child’s healthcare provider can
do a throat culture or rapid antigen detection test (RADT) to see if your child has
Children with damaged heart valves from rheumatic heart disease need to keep their
teeth and gums clean. They should also have regular dental exams with preventive antibiotics.
These steps can help prevent infections of the damaged heart valves.
How can I help my child live with rheumatic heart disease?
Your child will need to have regular exams to check on their heart. They may also
have repeat diagnostic tests of the heart.
If your child has had rheumatic fever, the healthcare provider may prescribe periodic
antibiotics to take for several years or up to a certain age. The antibiotics keep
rheumatic fever from coming back. They also lower the risk for heart damage. It's
important that your child continue to take antibiotics as prescribed.
When should I call my child's healthcare provider?
Call your child's healthcare provider if your child has any of these:
Key points about rheumatic heart disease in children
Rheumatic heart disease is long-term damage to heart valves that is a complication
of rheumatic fever.
Rheumatic fever stems from untreated strep infections.
You can prevent rheumatic heart disease by knowing what strep throat looks like and
getting treatment for it.
Rheumatic heart disease is treated with rest and medicine. If valve damage occurs,
your child may need surgery.
Before you agree to the test or the procedure for your child make sure you know:
The name of the test or procedure
The reason your child is having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
When and where your child is to have the test or procedure
Who will do the procedure and what that person’s qualifications are
What would happen if your child did not have the test or procedure
Any alternative tests or procedures to think about
When and how will you get the results
Who to call after the test or procedure if you have questions or your child has problems
How much will you have to pay for the test or procedure