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Rheumatic Fever

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    TOP

Rheumatic fever is caused by a specific bacteria that causes strep throat. In this case, the body uses antibodies to fight the infection, but the antibodies also attack the heart.

Risk Factors    TOP

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

  • Having strep throat
  • Prior case of rheumatic fever

Symptoms    TOP

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    TOP

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 ECG.

Treatment    TOP

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

Antiobiotics are used to treat the strep infection. They 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

Note : Aspirin can cause serious complications in some children with certain infections. It is best to avoid aspirin or aspirin products for children with infections.

Rest

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

Prevention    TOP

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
https://www.nhlbi.nih.gov

CANADIAN RESOURCES:

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

References:

Acute rheumatic fever. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated May 31, 2017. Accessed August 14, 2017.
Rheumatic fever. Texas Heart Institute website. Available at:
...(Click grey area to select URL)
Updated August 2016. Accessed September 26, 2014.
Robertson KA, Volmink JA, Mayosi BM, et al. Antibiotics for the primary prevention of acute rheumatic fever. BMC Cardiovasc Disorders. 2005;5(1):11.
Last reviewed August 2017 by David L. Horn, MD, FACP
Last Updated: 9/30/2013

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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