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What are the Possible Complications of Rheumatic Heart Disease?

What are the Possible Complications of Rheumatic Heart Disease?

Rheumatic heart disease (RHD) develops when acute rheumatic fever (ARF) causes permanent scarring and damage to the heart valves. Heart valves help push blood through the chambers of the heart and to the rest of the body.

However, valves that have been damaged by RHD may cause the blood to move in the wrong direction and affect the circulatory system. A heart that cannot effectively pump blood may lead to unfavorable prognosis and complications of rheumatic heart disease.

Rheumatic Heart Disease: All You Need to Know

What are the possible prognosis and complications of rheumatic heart disease?

The complications of RHD are many, but most of these are preventable through proper care and medical attention.

Here are some rheumatic heart disease complications and symptoms you should watch out for.

Heart failure

Scarred and damaged valves that are severely narrowed or leaking make it difficult for the heart to sufficiently pump blood throughout the body. If the heart does not function well, it may lead to the build-up of fluids in the lungs and body. This fluid build-up may then cause difficulty breathing, swelling of the belly, legs and ankles, and weakness and easy fatigability.

Immediate treatment is important to prevent rheumatic heart disease complications symptoms from worsening, and even prevent disability or death. This is one of the detrimental prognosis and complications of rheumatic heart disease that needs immediate medical attention.


Stroke occurs when a part of the brain fails to receive enough blood supply. There are two ways a stroke may happen:

  • Hemorrhagic stroke. A blood vessel bursts.
  • Ischemic stroke. A clot blocks a blood vessel.

There is a higher risk for ischemic stroke among people with RHD, because blood clots that form in the heart may disrupt blood flow to parts of the brain. Stroke is one of the prognosis and complications of rheumatic heart disease that can be prevented with medication. People with RHD may be prescribed blood thinners to lessen their chances of having a stroke.


Atrial fibrillation (AF), an abnormal heart rhythm, is a form of arrhythmia where the atria trembles instead of beats. Damage to the heart valves may cause changes in the shape of the heart, which is why people with RHD have an increased risk of AF.

AF tends to be linked to other unfavorable prognosis and complications of rheumatic heart disease. It may cause shortness of breath, as well as palpitations, and lead to heart failure. The risk of stroke can also increase significantly because of AF.

Bacterial Endocarditis

Infective Endocarditis (IE) is a bacterial infection of the inner lining of the heart, usually the heart valve. IE is more likely to occur in scarred or damaged valves due to RHD.

IE may cause fevers and makes it difficult for the heart to pump blood efficiently. Diagnosing IE can be difficult as it does not respond well to antibiotic treatment.

Lowering the risk of IE is an important part of managing RHD. Luckily, IE is one of the prognosis and complications of rheumatic heart disease that can be prevented by following good dental hygiene. The mouth is often where IE-causing bacteria enters the body. Practicing good dental hygiene can minimize risk.

RHD complications in pregnancy and delivery

Those who are pregnant have a higher risk of acquiring poor prognosis and complications of rheumatic heart disease.

Women with RHD who are pregnant and are in labor have higher chances of contracting illnesses and their lives are put at risk. When a woman is pregnant or in labor, her heart has to work harder to cope with the changes in the body. A heart affected by RHD may have trouble adjusting to these changes, and lead to heart failure.

It may be difficult to determine whether a woman is experiencing rheumatic heart disease complications, symptoms of heart failure, or she is just in the stage of late pregnancy. If heart failure is left untreated, it may lead to cardiovascular collapse or death.

Women who undergo heart valve surgery and those who have metal heart valves are at risk of severe bleeding due to blood-thinning medications that may be prescribed during pregnancy. These medications may also affect the development of the unborn child. It is best to consult your doctor regarding these concerns if you are pregnant.

How can the poor prognosis and complications of rheumatic heart disease be treated?

In most cases, damage to the heart valves cannot be reversed. Treatments are prescribed to prevent further damage to the heart valves, and to manage rheumatic heart disease complications symptoms.

For heart failure. Medications to prevent heart failure are often diuretics. These induce the kidneys to produce more urine to help flush out and reduce the amount of fluid in the body. Diuretic medications are often given in tablet form, but some patients may have to go to the hospital to receive the medicine via intravenous drip.

For arrhythmia. There are some medications that are available that help keep the heart beating at a normal rate and rhythm.

Anticoagulation medications. Anticoagulation medications, or blood-thinning medication, reduces the chances of blood clots forming in the heart of people with RHD.

Heart surgery. Heart surgery may be required in some cases of advanced RHD if the doctor thinks it is necessary to repair the valves damaged as a result of the RHD.

Living with rheumatic heart disease

It is normal to be worried or concerned after being diagnosed with RHD, especially knowing and understanding the possible prognosis and complications of rheumatic heart disease. However, thanks to the advancement of science and medicine, there are many ways to successfully manage RHD and prevent the worsening of symptoms. Consult your doctor for possible treatment and any other concerns you may have about your heart health and overall condition.

Learn more about rheumatic heart disease, here.


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Hello Health Group does not provide medical advice, diagnosis or treatment.

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Written by Fleur Angeline Quesada Updated Aug 10, 2020
Medically reviewed by Mike-Kenneth Go Doratan, M.D.