Rheumatism of the heart 2024 | Diagnosis and treatment in the light of modern technologies

Rheumatism of the heart Diagnosis and treatment in the light of modern technologies

What is Rheumatism of the heart

Rheumatism of the heart is heart valve damage caused by rheumatic fever. Bacterial infections called streptococcal (invasive) infections of Group A can cause rheumatic fever.

An infection, such as a sore throat or scarlet fever, triggers the body’s immune response. It causes inflammation throughout the body, including in the heart.

If untreated, inflammation can lead to permanent heart valve damage and serious health problems.

People most at risk of developing rheumatic heart disease

Children and adolescents with streptococcal sore throat: streptococcal sore throat is a bacterial infection that can lead to rheumatic carditis.
People with a family history of rheumatic heart disease: if someone in your family has rheumatic heart disease, you are more likely to have it too.
People living in areas with high rates of strep throat: strep throat infections spread easily, so living in an area with high rates of this infection increases the risk of rheumatic heart disease.

Other risk factors for rheumatism of the heart include:

People with weak immune systems: People with weak immune systems, such as people with autoimmune diseases or undergoing chemotherapy, are more likely to develop rheumatic heart disease.
Malnourished people: Malnutrition can weaken the immune system and increase the risk of rheumatic heart disease.
People living in poverty: People living in poverty have a higher risk of rheumatic heart disease for several reasons, including poor nutrition and lack of health care.

Rheumatic heart disease can damage heart valves, which can lead to heart failure or other heart problems.

Therefore, it is important to identify risk factors for these diseases and get medical care if you are at risk.

Symptoms of rheumatic heart disease

Symptoms of rheumatic heart disease vary depending on the severity of the disease and the extent of damage to the heart valves.
In general, the symptoms of rheumatic heart disease include:

Pain in the joints: pain in the joints is usually intermittent and often affects large joints, such as the joints of the knees, ankles and elbows.
Fever: body temperature may rise to 38 degrees Celsius or more.
Skin rash: a rash may appear on the skin, usually on the chest or abdomen.
Fatigue: the patient may feel tired and exhausted.
Difficulty breathing: the patient may have difficulty breathing, especially when exercising or when lying down.
Whistling in the heart: the doctor may hear a whistling sound in the heart when examining the patient.

Causes of rheumatic heart disease

Heart valve inflammation from rheumatic fever causes rheumatic heart disease. Damage may occur immediately.
Or it can develop over time from repeated bacterial infections. Constant inflammation leads to scarring of the heart valve and stenosis.

The disease tends to affect the mitral and aortic heart valves. These valves control blood flow if the valves do not work, blood leaks into the heart instead of flowing out of the heart.

Diagnosis of rheumatic heart disease

Rheumatic heart disease is diagnosed based on a combination of factors, including:

Medical history: the doctor will ask about your medical history, including any previous medical conditions and your family history of rheumatic heart disease.
Physical examination: the doctor will examine your heart, lungs and joints for any signs or symptoms of the disease.
Blood tests: the doctor may ask you to take blood tests to determine the presence of inflammation or other signs of the disease.
Imaging tests: your doctor may ask you to do imaging tests, such as an ultrasound or MRI, to assess the condition of your heart.

If the doctor suspects that you have rheumatic heart disease, he may recommend additional tests to confirm the diagnosis.

Blood tests

Blood tests help diagnose rheumatic heart disease by determining the presence of inflammation or other signs of the disease. These tests may include the following:

Rapid blood deposition (ESR): elevated ESR indicates the presence of inflammation.
C-reactive protein (CRP): elevated CRP indicates inflammation is also present.
Antibody tests: antibody tests can help determine the presence of a bacterial infection, such as strep throat.

Imaging tests

Imaging tests help diagnose rheumatic heart disease by assessing the condition of your heart. These tests may include the following:

Cardiac ultrasonography: cardiac ultrasonography can help identify any damage to the heart valves.
Magnetic resonance imaging of the heart: magnetic resonance imaging of the heart can help provide more detailed images of the heart valves.

Treatment of rheumatic heart disease

Treatment of rheumatic heart disease depends on the severity of the disease and the extent of damage to the heart valves. In general, treatment includes:

Antibiotics: Antibiotics are used to kill the bacteria that cause strep throat, which is the main cause of rheumatic heart disease. Antibiotics are usually recommended to be taken for 10 days.
Anti-inflammatory drugs: anti-inflammatory drugs, such as aspirin or non-steroidal anti-inflammatory drugs (NSAIDs), are used to relieve inflammation and joint pain.
Heart medications: some people may need to take heart medications, such as diuretic medications or blood pressure medications, to help the heart function properly.

In some cases, the patient may need surgery to repair or replace a damaged heart valve.

Surgery

In some cases, the patient may need surgery to repair or replace a damaged heart valve.

Surgery may be recommended if the damaged valve is causing serious heart problems, such as heart failure or heart rhythm disturbance.

Repair of heart valve

Heart valve repair is a surgical procedure in which the damaged heart valve is repaired.

This can include fixing holes in the valve, separating conjugated valve folds or replacing part of the valve.

Preparation for heart valve repair

Before the heart valve repair is performed, the patient will need to perform some tests, such as:

Echocardiography: can help determine the type of damaged valve and how damaged it is.
Heart MRI: It can provide more detailed images of the damaged valve.
Blood tests: can help assess the patient’s general health.

Cardiac valve repair procedure

Heart valve repair can be done through a chest incision or through a leg incision. The incision type depends on the type of damaged valve and the extent of its damage.

In the procedure of repairing the heart valve through a chest incision, an incision is made in the middle of the chest, then the chest bones are opened to detect the heart.

Then an incision is made in the heart to repair the damaged valve.

In the procedure of repairing the heart valve through an incision in the leg, an incision is made in the groin, then a thin tube (line) is inserted through the femoral artery into the heart.

The catheter is then used to repair the damaged valve.

Recovery period of heart valve repair

The recovery period of heart valve repair usually takes 4 to 6 weeks. During this period, the patient will need to stay in hospital until he recovers from surgery.

The patient will also need to take medication as directed.

Heart valve replacement

Heart valve replacement is a surgical procedure in which a damaged heart valve is replaced with an artificial valve. An artificial valve can be made of metal, fabric, or a combination of the two.

The main types of artificial heart valves:

Mechanical heart valves: they are made up of metal components, such as chromium, nickel or titanium. Mechanical heart valves usually last a lifetime, but require lifelong intake of anticoagulant drugs to prevent blood clots.
Histological heart valves: they are made up of human or animal heart tissue. Tissue heart valves usually last 10-15 years, do not require taking anticoagulant drugs.
Hybrid heart valves: consist of a combination of metal and tissue components. Hybrid heart valves usually last 15-20 years, in some cases they do not require taking anticoagulant drugs.

Preparation for heart valve replacement

Before the heart valve replacement procedure, the patient will need to undergo some tests, such as:

Echocardiography: it can help determine the type and extent of the damaged valve.
Magnetic resonance imaging of the heart: it can provide more detailed images of the damaged valve.
Blood tests: they can help assess the patient’s overall health.

Heart valve replacement procedure

Heart valve replacement can be performed through an incision in the chest or through an incision in the leg. The type of incision depends on the type of damaged valve and how damaged it is.

In the procedure of heart valve replacement through a chest incision, an incision is made in the middle of the chest, then the chest bones are opened to expose the heart.

Then an incision is made in the heart to replace the damaged valve.

In the procedure of heart valve replacement through an incision in the leg, an incision is made in the thigh, and then a thin tube (catheter) is inserted through the femoral artery into the heart.

A catheter is then used to replace the damaged valve.

Recovery period of heart valve replacement

The recovery period of heart valve replacement usually takes 4 to 6 weeks. During this period, the patient will need to stay in hospital until he recovers from surgery.