Rhematic fever is an inflammatory illness that sometimes follows streptococcal throat infections,most commonly in children and young adults. It is an autoimmune disorder; the antibodies produced to combat the original infection damage connective tissues, including the heart,joints and skin.
Death rarely occurs in the acute phase,but after recovery there may be permanent damage to the heart valves,eventually leading to disability and possibly cardiac failure.
Acute rheumatic heart disease.
In the acute stages,all layers of the heart wall are inflamed. The heart valves,especially in the mitral valve,are frequently affected. Fibrotic nodules develop on their cusps,which shrink as they age,distorting the cusp and causing stenosis and incompetence of the valve. The inflamed myocardium can fail,leading to signs of heart failure,including tachycardia,breathlessness and cardiac enlargement.
Chronic rheumatic heart failure.
Inflamed tissue becomes fibrous as it heals,and this fibrous tissue interferes with the action of the myocardium and the heart valves. Chronic fibrotic changes in the pericardium and myocardium cause heart failure.
