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 heart disease.

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 as:

  • Trouble breathing
  • Chest pain
  • Swelling (edema) of the feet and ankles
  • Heart murmur

Your child may also have other signs and symptoms of rheumatic fever. These include:

  • Joint pain and swelling 
  • Rash
  • Small, hard, round bumps under the skin (nodules)
  • Irregular or jerky movements
  • Belly (abdominal) pain
  • Bloody nose
  • Fever
  • Lightheadedness or dizziness
  • Fatigue

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 hand.