Rheumatic fever is an inflammatory condition. It involves the connective tissue in the body. The most severe complication is rheumatic heart disease. This condition may permanently damage the heart valves. Valves control the flow of blood to and from the heart.
Diseased Heart Valve
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Rheumatic fever is caused by group A
Streptococcus pharyngitis, also known as
strep throat. In this case, the body uses antibodies to fight the infection, but the antibodies also attack the heart.
Rheumatic fever is more common in children and adolescents aged 5-15 years. Other factors that may increase your chance of rheumatic fever include: Having strep throatPrior case of rheumatic fever
Symptoms usually appear 2 to 4 weeks after a strep infection. They may include: Pain and swelling in large jointsFeverWeaknessMuscle achesShortness of breathChest painNausea and vomitingHacking coughCircular rashLumps under the skinAbnormal, sudden movements of arms and legs
The doctor will ask about your symptoms and medical history. A physical exam will be done. This will include a careful exam of your heart.
Other tests may include:
Samples may be taken of your bodily fluids and tissues. This can be done with:
Blood testsThroat culture
You may need to have pictures taken of your heart. This can be done with:
You may need to have your heart activity measured. This can be done with an
The goals of treatment are to: Kill the strep bacteriaTreat the inflammation caused by the rheumatic feverTreat any cardiac problemsPrevent future cases of rheumatic fever
Antiobiotics are used to treat the strep infection. They may be given by mouth or injection.
To help with joint pain and swelling: Aspirin
or other nonsteroidal anti-inflammatory drugs (NSAIDs)—only if advised by your doctorCorticosteroids may be used if NSAIDs are not effective or if there is inflammation of the heart
In some cases, the inflammation can be severe. You may have to rest for a period of time.
It is important to treat strep throat with antibiotics right away. This will help prevent rheumatic fever. If you or your child has a
and a fever that lasts more than 24 hours, contact your doctor.
Nausieda PA, Grossman BJ, Koller WC, Weiner WJ, Klawans HL. Sydenham chorea: An update.
Rheumatic fever. Texas Heart Institute website. Available at:
http://www.texasheart.org/HIC/Topics/cond/rheufev.cfm. Updated August 2014. Accessed September 26, 2014.
Robertson KA, Volmink JA, Mayosi BM, et al. Antibiotics for the primary prevention of acute rheumatic fever.
BMC Cardiovasc Disorders. 2005;5(1):11.
Spagnuolo M, Pasternack B, et al. Risk of rheumatic fever recurrences after streptococcal infections: Prospective study of clinical and social factors.
N Engl J Med. 1971;285(12):641-647.
Last reviewed September 2016 by David Horn, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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