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Understanding Rheumatic Heart Disease (RHD): Prevention, Treatment and Vulnerable Communities

Rheumatic Heart Disease

What is Rheumatic Heart Disease (RHD)?

Rheumatic heart disease (RHD) is a rare but serious condition that can develop after a bacterial infection called group A streptococcus (Strep A). If left untreated, this infection can cause the body’s immune system to attack the heart, leading to long-term damage and scarring of the heart valves. This damage makes it harder for the heart to pump blood effectively throughout the body.

Rheumatic Heart Disease can cause symptoms such as:

These symptoms can make everyday tasks, such as housework or walking, feel more difficult. If you experience any of these signs, it is important to see a doctor to help manage your heart health and maintain your quality of life.

 

How is RHD Treated?

There are different ways to manage and treat RHD, depending on how severe the condition is. Treatment aims to prevent further damage, manage symptoms, and improve overall heart health. The following are common treatment options:

  • Antibiotics: Can help treat and prevent further infections and reduce the risk of complications.
  • Medications: Certain medications can help control symptoms, such as reducing fluid buildup, lowering blood pressure, or preventing blood clots.
  • Surgery: In more severe cases, surgery may be needed to repair or replace damaged heart valves, such as valve repair or replacement, balloon valvuloplasty, or pacemaker implantation.
  • Ongoing care: Regular, supportive care is essential for managing RHD. Regular check-ups, lifestyle changes such as eating well and staying active, and psychosocial support are important for the long-term management of RHD.

Given societal improvements in living conditions and access to healthcare, the spread of Strep A has been reduced significantly, and infections can be treated early, reducing complications like rheumatic heart disease. For these reasons, RHD has largely been eradicated within Australia, yet still disproportionately impacts Aboriginal and Torres Strait Islander populations.

 

Understanding Rheumatic Heart Disease (RHD): Prevention, Treatment and Vulnerable Communities 1
Source: Australian Science Communicators

 

RHD in Aboriginal and Torres Strait Islander Communities

While RHD is now uncommon in the general Australian population, it remains a significant health concern for Aboriginal and Torres Strait Islander communities. This is largely due to socioeconomic and systemic inequities that many Indigenous communities experience, such as:

  • Overcrowded housing which increases the spread of infections.
  • Limited access to healthcare which makes it harder to get an early diagnosis and treatment.
  • Economic and social challenges can contribute to poor overall health and well-being.

These factors create a cycle where untreated Strep A infections lead to repeated rheumatic fever episodes, ultimately resulting in chronic RHD.

 

How Does Rheumatic Heart Disease (RHD) Affect Daily Life?

RHD can affect more than just the heart—it can also impact the joints, skin, and brain. However, heart damage is the most serious concern, causing inflammation and scarring of heart valves that results in a narrowing and leaking of these structures. Over time, the heart has to work harder to pump blood, which can lead to complications such as:

People living with RHD may need to take medications for life and, in some cases, undergo surgery.

 

Preventing and Managing Rheumatic Heart Disease (RHD) in Vulnerable Communities

To reduce the impact of RHD in Indigenous and Torres Strait Islander communities, a comprehensive approach is needed, focusing on:

  • Community prevention programs to improve housing conditions, reduce overcrowding and increase awareness about Strep A infections and the importance of early treatment.
  • Improved healthcare access, including mobile clinics, telehealth services, and screenings to ensure timely diagnosis and treatment.
  • Government support, with policies to close the healthcare gap by funding RHD-specific programs and investing in research and treatment options.

 

Taking Action Against RHD

Rheumatic heart disease remains a preventable yet persistent health challenge, particularly among Aboriginal and Torres Strait Islander communities.

While improvements in healthcare access and living conditions have significantly reduced RHD in Australia, by focusing on prevention, early diagnosis, proper treatment, and long-term management, we can address the root causes of this disease and improve heart health outcomes for everyone.

 

References

  1. Cleveland Clinic. (n.d.). Rheumatic Heart Disease: Symptoms, Causes &; Treatment. Retrieved from https://my.clevelandclinic.org/health/diseases/21485-rheumatic-heart-disease
  2. World Heart Federation. (n.d.). Rheumatic Heart Disease. Retrieved from https://world-heart-federation.org/what-we-do/rheumatic-heart-disease/
  3. Johns Hopkins Medicine. (n.d.). Rheumatic Heart Disease. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/rheumatic-heart-disease
  4. Frontiers in Cardiovascular Medicine. (2020). Rheumatic Heart Disease: Pathogenesis and Prevention. Retrieved from https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2020.612716/full