The cause for rheumatic heart disease (RHD) is rheumatic fever. Rheumatic fever is a febrile disease. It is caused by group A beta hemolytic streptococci. Initially, it affects the throat (strepto­coccal sore throat). Later it affects the joints. Ultimately it affects the heart. The usual saying is ‘it licks the joints and bites the heart’.

Cardiac manifestations

Rheumatic heart disease occurs mainly in the form of mitral stenosis. It may also affect aortic, pulmonary and tricuspid valves. The complications of RHD are pulmonary hypertension, congestive cardiac failure, sub acute bacterial endocarditis (SBC) and atrial fibrillation.

Prevention and control


1. Identification and treatment of cases with streptococcal sore throat. Throat swab culture must be done in suspected cases. Positive cases must be treated with long acting penicillin.

2. By means of School health services, school children can be screened. This will help in early detection and treatment.

By improving socio economic conditions. Improvement of living conditions, better housing and breaking of poverty can prevent infection.