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Rheumatic heart disease
Is rheumatic heart disease with atrial fibrillation severe?
Rheumatic heart disease often results from repeated instances of rheumatic fever leading to issues such as heart valve malformations, rheumatic inflammation of the heart, or pericarditis. Common symptoms include accelerated heartbeat, tightness in the chest, and difficulty breathing. In cases of severe mitral stenosis combined with significant enlargement of the left atrium, atrial fibrillation can occur, which is likely to lead to the formation of atrial thrombi in patients with mitral valve issues. Hence, this type of disease can cause considerable complications, primarily leading to further deterioration of heart function. Secondly, the formation of cardiac thrombi due to atrial fibrillation might lead to the thrombus dislodging, potentially resulting in sudden symptoms like paralysis, aphasia, or even sudden death. Therefore, patients with rheumatic heart disease concurrent with atrial fibrillation should seek treatment promptly. Alleviating the narrowing would be ideal. If that is not possible, consistent anticoagulation therapy should be maintained to prevent the formation of thrombi.
Is rheumatic heart disease caused by rheumatism?
Rheumatic heart disease is caused by rheumatism. Patients with rheumatic heart disease can have typical symptoms of rheumatism, but some people do not have a history of rheumatic disease. However, upon detailed inquiry, it may be considered that rheumatic fever exists. Rheumatic heart disease occurs when rheumatic fever affects the heart valves, often involving all the heart valves. The most commonly affected valves are the mitral and aortic valves. This can lead to adhesion, thickening, and stiffness of the valves, causing narrowing of the mitral valve along with regurgitation, and can also lead to combined valve disease, where mitral valve disease is accompanied by aortic valve disease. Clinical symptoms can present as episodes of heart failure and arrhythmias. Treatment requires mitral and/or aortic valve replacement surgery.
What does rheumatic heart disease look like?
Rheumatic heart disease can cause mitral stenosis, and severe mitral stenosis can present with a "mitral facies," characterized by a ruddy complexion on both cheeks. Normally, the area of the mitral valve orifice is about four to six square centimeters. When the valve area decreases to 1.5 to 2.0 square centimeters, it is considered mild stenosis. Moderate stenosis is from 1.5 to 1.0 square centimeters. Severe stenosis is defined as less than 1.0 square centimeter. For moderate to severe mitral stenosis, if there is progressively worsening dyspnea or pulmonary hypertension, mechanical intervention is required to relieve the mitral stenosis and alleviate symptoms. Interventional and surgical treatments are available, including percutaneous balloon mitral valvuloplasty, mitral valvotomy, and artificial valve replacement. The specific method to be used should be determined by a specialist.
What should I do if rheumatic heart disease catches a cold?
Patients with rheumatic heart disease, if they find they have caught a cold, should go to the hospital for an examination as soon as possible, including blood tests and an electrocardiogram. If a viral infection is suspected, antiviral treatment should be administered promptly. If a bacterial infection is suspected, antibiotics should be given promptly to control the infection. This can prevent the cold from turning into a lower respiratory tract infection or pneumonia. Because if a cold is not treated in time, it often can trigger an episode of heart failure in patients with rheumatic heart disease and can also lead to a further aggravation of rheumatic disease. Therefore, patients with rheumatic heart disease should prevent infections, and the use of long-acting penicillin once a month is very necessary.
Causes of fatigue in rheumatic heart disease
If the patient is diagnosed with rheumatic heart disease, and exhibits symptoms such as fatigue, numbness, or weak limbs, it could indicate a decline in heart function. It is recommended that the patient visit a hospital for a cardiac ultrasound to rule out these issues, as this condition is treatable. Currently, the treatment primarily focuses on symptomatic relief and improving heart function using cardiotonic diuretics, which can alleviate the patient’s current condition. If the patient experiences palpitations, difficulty breathing, or other similar symptoms, immediate attention is necessary. Ongoing monitoring of the patient's heart rate, blood pressure, and pulse changes is essential. If there is a high heart rate, or symptoms like swelling in the lower limbs, diuretics may be used to relieve these symptoms.
Can mild rheumatic heart disease be pregnant?
Generally, for patients with mild rheumatic heart disease, pregnancy is not recommended. Pregnancy can sometimes increase the burden on the heart, leading to heart failure. If this condition is treated in time, or if the patient has relatively good heart function and rheumatic heart disease rarely recurs, pregnancy can still be considered for young female patients. However, for rheumatic heart disease patients experiencing palpitations and chest tightness, it is best not to consider pregnancy. This condition can increase the load on the heart, especially in the late stages of pregnancy, and may further exacerbate heart failure.
Can rheumatic heart disease eat seafood?
For patients with rheumatic heart disease, it is recommended to avoid seafood in their diet. This is because seafood is relatively stimulating and can cause allergic reactions in patients. It is advisable for patients with rheumatic heart disease to follow a light diet, especially consuming easily digestible foods. During this period, the gastrointestinal function of patients is not very good, and there may be some congestion in the gastrointestinal tract, leading to a decrease in appetite. Therefore, it is even more important to eat foods that are easy to digest and pass through the digestive system. It is also important to maintain regular bowel movements. Particularly, spicy and stimulating foods should be avoided. Moreover, regular check-ups of the electrocardiogram and cardiac ultrasound are necessary.
Can rheumatic heart disease cause angina?
Rheumatic heart disease most commonly manifests as rheumatic myocarditis, pericardial thickening, or pericardial effusion. The majority of patients also present with mitral valve stenosis and insufficiency, and some also have aortic valve stenosis and insufficiency. When patients have severe aortic valve stenosis or severe aortic valve insufficiency, it leads to insufficient blood supply from the aorta, causing inadequate coronary circulation, which then can lead to angina.
The difference between rheumatic heart disease and myocarditis
Rheumatic heart disease refers to changes in the heart and heart valves caused by a disruption in the body's immune system following infection by Group A Streptococcus. Some also exhibit signs of heart inflammation and pericardial effusion, commonly presenting mitral stenosis, aortic valve stenosis or insufficiency, and tricuspid valve insufficiency. Myocarditis, on the other hand, refers to direct invasion of the heart muscle by viruses or bacteria, leading to heart muscle damage and cardiac dysfunction. Some cases present with arrhythmias, while others exhibit heart failure or shock, which can be severe enough to cause death. Generally, rheumatic heart disease has a longer course of illness, whereas myocarditis tends to improve within about two weeks. However, fulminant myocarditis has a high mortality rate, often accompanied by symptoms of heart failure, and some patients may suffer from long-term arrhythmias as a complication.
Does rheumatic heart disease cause dizziness?
Patients with rheumatic heart disease primarily exhibit symptoms of rheumatic myocarditis, pericarditis, or lesions of the mitral valve, aortic valve, and tricuspid valve including the pulmonary valve, with mitral stenosis being the most common. Generally, severe heart disease can impair the heart's pumping ability, leading to insufficient blood supply to the brain, causing dizziness. Some individuals with mitral stenosis may experience an enlargement of the atrium, leading to atrial fibrillation. Once atrial fibrillation occurs, the left atrial appendage can form blood clots, increasing the risk of clot detachment. If a clot detaches, it can pass directly through the right ventricle into the cerebral arteries, causing a major artery embolism that results in dizziness. In severe cases, this can lead to sudden death in patients.