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Rheumatic heart disease

4-minute read

What is rheumatic heart disease?

Rheumatic heart disease is a condition that develops when the body's heart valves are damaged by acute rheumatic fever (also called rheumatic fever). Rheumatic heart disease is a serious, disabling, sometimes fatal condition. But it is also entirely preventable.

Who is at risk of rheumatic heart disease?

You can develop rheumatic heart disease if you have had rheumatic fever. Rheumatic heart disease often begins as a strep throat (bacterial infection of the throat) in childhood, which then progresses to rheumatic fever.

People are at greater risk of developing rheumatic fever if they have poor living conditions, including living in overcrowded housing, and they have limited access to medical care.

Australia has some of the world's highest recorded rates of rheumatic fever and rheumatic heart disease. It mainly affects Aboriginal and Torres Strait Islanders living in remote areas, especially children, adolescents and young adults.

Because rheumatic heart disease is more common in some families, researchers are looking at what role genes might play.

What are the symptoms of rheumatic heart disease?

People with rheumatic heart disease may not notice symptoms for many years. The symptoms will depend on the type of heart damage, and how serious it is.

People with mild rheumatic heart disease may have a heartbeat that sounds abnormal (known as a heart murmur) which doctors can hear using a stethoscope.

Symptoms of moderate to severe rheumatic heart disease include:

  • chest pain
  • shortness of breath when exercising or lying down
  • weakness and tiredness
  • palpitations
  • swollen legs and face

Over time, severe rheumatic heart disease can cause serious complications such as:

CHECK YOUR SYMPTOMS — Use the rheumatic heart disease Symptom Checker and find out if you need to seek medical help.

How is rheumatic heart disease diagnosed?

If your doctor suspects you might have rheumatic heart disease, you will probably need to see a specialist who can diagnose it.

In most cases, doctors use an ultrasound of the heart, known as echocardiography, to diagnose rheumatic heart disease.

X-rays and echocardiograms (ECGs) can also help diagnose heart problems.

How is rheumatic heart disease treated?

The treatment of rheumatic heart disease is designed to do 2 things: manage problems caused by any heart damage you have now, and prevent future damage.

To manage any heart problems you have now, doctors may give you medicine:

  • to keep your heart beating at a more normal rate and rhythm (for arrhythmia)
  • to prevent heart failure by reducing the amount of fluid in the body
  • to prevent blood clots from forming in the heart

Some people with rheumatic heart disease may need surgery to repair or replace their heart valves.

Follow-up care for rheumatic heart disease

If you have rheumatic heart disease, you will need regular check-ups with clinic staff, specialists and dentists.

Rheumatic heart disease can get worse if you have rheumatic fever again. To prevent this, you will need to go to a clinic every 3 to 4 weeks for penicillin injections.

These long-acting antibiotic injections are very important. Never miss or stop them without talking to a doctor.

You must also take very good care of your teeth. Regular brushing and dental checks reduce the risk of infections of the heart.

Can rheumatic heart disease be prevented?

Rheumatic heart disease is entirely preventable.

In many cases, people who have rheumatic fever can still avoid rheumatic heart disease by having regular penicillin injections.

Preventing rheumatic fever in the first instance is also important. This means getting an early diagnosis and treatment of strep throat infections that cause the fever.

The risk of getting a strep infection can be reduced by improving:

  • housing and living conditions
  • access to fresh food and a healthy diet
  • access to fresh water
  • availability of education about hygiene and hand-washing

More information


RHD Action (What is RHD?), RACGP (Fighting disadvantage), SA Health (SA Health - Rheumatic heart disease (RHD) & Acute rheumatic fever (ARF) including symptoms, treatment and prevention), RHD Action (Rheumatic heart disease - diagnosis), RHD Action (Just diagnosed - RHD), RHD Action (Heart surgery), RHD Action (Prevent overview), RHD Action (Complications of RHD), Menzies School of Health Research (The 2020 Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease), Medical Journal of Australia (Rheumatic heart disease in Indigenous children in northern Australia: differences in prevalence and the challenges of screening)

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Last reviewed: January 2021

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