Rheumatic Heart Disease in Children

February 25, 2022
Janelle Thomas MSN, RN
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Any heart-related diagnosis for a small child is a scary and challenging time for the entire family. This is especially the case for relatively rare conditions like rheumatic heart disease. Rheumatic heart disease in children is a preventable yet serious condition that affects the heart health of millions of children around the world.

In most situations with proper treatment, rheumatic heart disease in children does improve. But due to the often permanent damage it causes to the heart, there can be long-term effects. Understanding the steps for diagnosis, treatment, and care for this condition can help ensure the best possible outcome for anyone facing rheumatic heart disease.

What is Rheumatic Heart Disease?

Rheumatic heart disease describes when the heart valves become damaged due to a condition known as rheumatic fever. This inflammatory condition occurs most commonly in children aged five to 15. Although rare in the United States, rheumatic heart disease can occur here and in other developed countries.

If you or a loved one is dealing with rheumatic heart disease in children, the following overview can help you better understand this challenging illness and the most common treatment steps.

Rheumatic Heart Disease Risk Factors

Rheumatic heart disease is most prevalent in low- and middle-income countries but does occur in wealthier nations, according to the World Health Organization. In the United States, it was more common in the twentieth century but is still encountered in many indigenous, marginalized, and low-income communities.

The biggest risk factor for rheumatic heart disease and underlying cases of rheumatic fever is undiagnosed or undertreated strep infections. Children with repeated strep infections and reduced access to medical care represent the highest at-risk group for rheumatic heart disease. Scarlet fever, a specific strep infection that causes a bright red rash, is another disease that can lead to both rheumatic fever and rheumatic heart disease in children.

Rheumatic Heart Disease Causes

Rheumatic fever is caused by the body’s natural immune response to these bacterial infections. The result is increased inflammation throughout the body. In some cases, especially if there is a prolonged immune response, the inflammation can begin to damage important connective tissues, including in the joints, skin, brain, and/or heart.

When this inflammatory immune response begins to damage the heart, it is diagnosed as rheumatic heart disease.

Rheumatic Heart Disease Symptoms

Symptoms of rheumatic heart disease in children can begin anywhere from one to six weeks after a strep throat infection and include the following:

  • Fever
  • Painful and tender joints – most often in the knees, ankles, elbows, and wrists
  • Pain in one joint that migrates to another joint
  • Chest pains
  • Heart irregularities and murmurs
  • Difficulty breathing
  • Flat or slightly raised, painless rash with a ragged edge
  • Swelling in the feet or ankles
  • Fatigue
  • Lumps or nodules under the skin, painless
  • Uncontrolled arm, leg, and facial movements
  • Outbursts of unusual behavior, such as crying or inappropriate laughing, that accompanies Sydenham chorea

Since these symptoms can be similar to other conditions, you should always see a doctor for diagnosis if any of these are present.

Diagnosing Rheumatic Heart Disease

When diagnosing rheumatic heart disease in children, one of the first steps will always be to check for a recent strep infection since these are so commonly related. As standard procedure, doctors will also generally perform a full medical history review, ask questions about symptoms and recent activities, and perform a physical examination.

Additional diagnostic steps to diagnose rheumatic heart disease in children include:

  • Checking for heart murmurs or rubs through a stethoscope
  • Echocardiogram, an imaging test that uses sound waves to detect heart damage or dysfunction
  • Electrocardiogram, which measures electrical activity in the heart, usually to detect arrhythmias
  • Blood tests for indicators of infection or inflammation
  • Chest X-ray and/or cardiac MRI

Rheumatic Heart Disease Treatment

Specific treatment depends on the child’s age, overall health, and the severity of the condition. Antibiotics may be prescribed over a long period of time to ensure the bacterial infection has been fully eliminated and to prevent a recurrence.

Anti-inflammatory drugs are also common for reducing the inflammatory response and fever.

In cases of rheumatic heart disease with extensive damage, a pediatric cardiologist may recommend surgery to repair the heart.

Caring for a Child with Rheumatic Heart Disease

Whether recovering from the disease itself or related surgery, children with rheumatic heart disease can have complex and long-term care needs. Often, there will be ongoing monitoring to ensure the heart condition isn’t worsening and caregivers will need to ensure that the patient takes any prescribed medication as indicated. Children may also commonly deal with activity restrictions and certain side effects from treatment.

For many families, pediatric home health services can be a necessary and beneficial aspect of the treatment and recovery process for rheumatic heart disease.

Contact Care Options for Kids for Home Health Care

It can be hard to balance your time between work, home, and caring for a child. That’s why our team of skilled professionals at Care Options for Kids is here to help. We have been enforcing precautionary measures and following the Centers For Disease Control (CDC) guidelines for COVID-19 to ensure the safety and health of our clients and employees.

Our home health care services offer support in the comfort of your home. We refer loving and competent nurses to provide customized care for families — from a few hours a day to around-the-clock supervision. Contact us directly to speak with a home health care professional or request a free in-home assessment. Together we can determine the best plan of action to keep your loved ones happy and healthy.

If you or a loved one are considering Pediatric Home Health Care Services, contact the caring staff at Care Options for Kids. Call today at (888) 592-5855.