Conditions & Treatments

Rheumatic Heart Disease

Rheumatic heart disease is a condition in which permanent damage to heart valves is caused by rheumatic fever.

Rheumatic Heart Disease

What is rheumatic heart disease?

Rheumatic heart disease is a condition in which permanent damage to heart valves is caused by rheumatic fever. The heart valve is damaged by a process that generally begins with an infection caused by streptococcus bacteria. In some cases, strep throat or scarlet fever can eventually progress to rheumatic fever.

Illustration of the heart and heart valves
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The effects of rheumatic fever:

  • Rheumatic fever, an inflammatory disease, can affect many connective tissues, especially in the heart, joints, skin, or brain.

  • Rheumatic fever can occur at any age, but usually occurs in children ages 5 to 15 years old.

  • Rheumatic fever causes heart damage--particularly scarring of the heart valves--forcing the heart to work harder to pump blood and may eventually cause congestive heart failure. Heart-related symptoms may take years to develop. 

What are the symptoms of rheumatic fever?

The following are the most common symptoms for rheumatic fever; however, each individual may experience symptoms differently. Symptoms, which vary greatly, typically begin one to six weeks after a bout of strep throat, although, in some cases, the infection may have been too mild to have been recognized. Symptoms may include:

  • Fever

  • Swollen, tender, red and extremely painful joints--particularly the knees, ankles, elbows, or wrists

  • Nodules over swollen joints

  • Red, raised, lattice-like rash, usually on the chest, back, and abdomen

  • Shortness of breath, chest discomfort 

  • Uncontrolled movements of arms, legs, or facial muscles

  • Weakness and shortness of breath

The symptoms of rheumatic fever may resemble other bone disorders or medical problems. Consult your health care provider for a diagnosis.

Treatment for rheumatic heart disease

Specific treatment for rheumatic heart disease will be determined by your health care provider based on:

  • Your overall health and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Treatment depends in large part on how much damage has been done to your heart valves. It may even include surgery to replace or repair a valve.

Since rheumatic fever is the cause of rheumatic heart disease, the best treatment is to prevent rheumatic fever from occurring. Penicillin and other antibiotics can usually treat strep throat (a streptococcus A bacterial infection) and stop acute rheumatic fever from developing.

People who have previously contracted rheumatic fever are often given continuous (daily or monthly) antibiotic treatments, possibly for life, to prevent future attacks of rheumatic fever and lower the risk of heart damage. Antibiotic therapy has sharply reduced the incidence and mortality rate of rheumatic fever or rheumatic heart disease. To reduce inflammation, aspirin, steroids, or nonsteroidal medications may be given. Surgery may be necessary to repair or replace the damaged valve.

Treatment Programs


Massachusetts General Hospital understands that a variety of factors influence patients' health care decisions. That's just one reason why we're dedicated to ensuring patients understand their diagnosis and treatment options. Because a single option might not serve all patients, we offer a wide range of coordinated treatments and related services across the hospital. Patients should consult with their primary care doctor or other qualified health care provider for medical advice and diagnosis information.

Select a treatment program for more information:



Heart Center

  • Corrigan Women's Heart Health Program
    The Elizabeth Anne and Karen Barlow Corrigan Women's Heart Health Program at the Massachusetts General Hospital Corrigan Minehan Heart Center cares for women of all ages through prevention and early detection of heart disease.
  • Heart Valve Program
    The Heart Valve Program at the Massachusetts General Hospital Corrigan Minehan Heart Center brings together specialists to evaluate, treat and provide long-term care for patients with heart valve conditions.
Imaging

  • Heart Imaging
    The Heart Imaging Program at Massachusetts General Hospital Imaging provides comprehensive diagnostic cardiac imaging, using state-of-the-art CT and MRI technology and with expert interpretation by specialty-trained cardiovascular radiologists.

The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.

Treating heart disease in Rwanda: Mass General team joins volunteer mission

On April 8th Terry Nearhos, RN, Jennifer Neary, cardiac sonographer, and J. Warren Harthorne, MD, departed for Kigali, Rwanda to join Team Heart in diagnosing and treating heart failure patients.

Innovative care at the Corrigan Minehan Heart Center

Learn more about the latest treatment options for this condition at the Corrigan Minehan Heart Center.