Birth defects of the heart and its vessels

Rheumatic heart disease is one of the most common cardiac afflictions seen in the country. A disease triggered by a seemingly innocuous childhood throat infection, it primarily affects the valves of the heart, leaving them narrowed and/or leaky. With it, the normal circulation of blood within the heart goes haywire and eventually cardiac failure ensues. But today, herbs and herbal product can rectify the situation. The disease can, in fact, also be prevented. This is borne out by the developed world where suitable preventive steps have brought the disease to near extinction.

What is rheumatic heart disease?
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At what age does rheumatic fever usually strike?

How common is rheumatic heart disease in India?

What are the major causes for the disease being so rampant in this country?

How exactly does a throat infection trigger rheumatic fever?

Usually, how long does it take before the heart becomes overtly diseased?

Which heart valves are commonly affected?

What are the common symptoms of valvular disease?

How is the diagnosis of a valvular disease established?

What is the treatment of rheumatic heart disease?

Are there any steps which can help prevent rheumatic heart disease?

What is rheumatic heart disease?   Top  

It is related to rheumatic fever, an inflammatory disease, that occurs as a delayed sequel to throat infection with a particular kind of bacterial germs, group A streptococci.

It all begins with a seemingly innocuous attack of bad throat (pharyngitis), or tonsilitis. The patient gets over it, but one to three weeks later rheumatic fever strikes. It may come all of a sudden, with pain, swelling, and stiffness in one or more joints, with fever, sweating and rapid heart rate, or it may be more crafty-causing mere tiredness, a general feeling of being unwell and loss of weight.

The large joints-knees, ankles, shoulders, and wrists-are principally affected. Characteristically, the pain and swelling shifts from one joint to the other, one joint improving as another becomes worse. Unlike in other forms of arthritis, the joints become normal when the attack is over.

The most seriously affected organ is the heart. All its three layers suffer from inflammation. In more serious cases, acute congestive heart failure supervenes, with serious risk to the patient's life. But usually, the results are not so dramatic. It is the valves which suffer the most. Over a period of time, they undergo scarring and fibrosis, and lose their suppleness and efficacy. With deformity overtaking them, they may become permanently narrowed. This condition is called valvular stenosis. In many cases, a different situation comes to pass. The component parts of the valve (called the cusps) are no longer able to come into close apposition at the time of valve closure. A tight seal fails to occur, the valve leaks, and the blood backtracks during cardiac contraction. This leaky condition of the valve is named valvular regurgitation. In course of time these changes of the heart valves have a serious bearing on circulati9n. Chambers of the heart enlarge, and the lungs get clogged with fluid.

Other than these short and long term changes, an acute attack of rheumatic fever may cause small, painless nodules to develop just under the skin in the region of elbows, knees, shoulder-blades, back of the head, and vertebral column; and a few days later, as joint pains subside, some patients develop sudden, aimless, irregular movements of the body, often ac­companied by muscle weakness and emotional instability, a condition called Sydenham's chorea". But these changes, like arthritis, usually subside on their own, leaving no aftermath.

It is only the damage to the heart which persists, and its severity is often related to recurrences and the seriousness of attacks of rheumatic fever.

At what age does rheumatic fever usually strike?   Top  

It is predominantly a disease of childhood and adolescence -commonly affecting ages between five and fifteen years.

How common is rheumatic heart disease in India?   Top  

It is the most common heart disease in India, below the age of twenty years. It accounts for 30-40% of all cardiac cases in hospital practice. Studies by various sources indicate that five to six school-going children in each thousand are affected, by it.

What are the major causes for the disease being so rampant in this country?

This in a way is a reflection on the sordid socio-economic conditions of the country. Crowding, with large families massed in small quarters, malnutrition, and poor body de­fences create ideal conditions for bacterial infection, and its spread. Furthermore, poverty, ignorance and dearth of treat­ment facilities prevent a quick and effective control of the infection.

How exactly does a throat infection trigger rheumatic fever?   Top  

Nobody knows for sure, and curiously, not all children who suffer a streptococcal throat infection develop rheumatic fever.

However, there is much evidence that it may be because of an immunological aberration. The bacteria seemingly shares a common antigen with the heart and thus it fools the body's defence mechanism to fire bullets at it.

Usually, how long does it take before the heart becomes overtly diseased?

This is quite variable. It depends upon several factors. The duration and severity of an attack, the amount of scarring it .causes in the valves and heart muscles, the frequency of recurrence of such attacks, and the rate at which calcium deposit and sclerosis occurs in the valves determine the pace at which the valvular disease develops. Patients have been known to come with full-blown symptoms even in their first ten years of life. More commonly, the disease manifests itself after the age of 20.

Which heart valves are commonly affected?   Top  

Rheumatic valvular disease most commonly affects the mitral valve, next the aortic valve, comparatively infrequently the tricuspid valve, and very rarely the pulmonary valve.

What are the common symptoms of valvular disease?

This depends upon the valve affected and the type of lesion it has.

When the mitral valve (the valve between left atrium and left ventricle) gets stenosed (narrowed), the first symptom is breathlessness. To begin with, it is felt only on exertion. But the extra demands of pregnancy, of rapid heart rate (due to any reason),' or occurrence of atrial fibrillation, may bring on breathlessness even at rest. The patient may be awakened at night with sudden attacks of breathlessness. Cough and blood­streaked sputum, and angina may be the other symptoms. As the heart failure worsens, the lungs may get flooded, leading to an acute medical emergency.

If the mitral valve gets leaky, the symptoms are totally different. In the beginning, the patient complains of undue fatigue. But as the disease gets severe, breathlessness begins.

In both the conditions, full-blown symptoms of heart failure eventually supervene. A regurgitant valve is prone to be com­plicated with life-threatening bacterial infection. In mitral stenos is with a fibrillating heart, blood clots may get into circula­tion with serious consequences, such as stroke.

With a leaky aortic valve (the valve at the exit point of the left ventricle), the earliest symptom is an unusual awareness of the heart-beat, particularly when lying on the left side. Sudden bouts of breathlessness may develop during sleep. As the disease progresses, feet may swell up because of heart failure. Some patients also develop symptoms of angina.

Aortic valve stenosis is a disease of adulthood. It is an extremely dangerous condition which causes sudden fainting spells, or anginal pain. As the left ventricle of the heart begins to fail, breathlessness develops.

Affliction of the tricuspid valve (the valve between the right atrium and the right ventricle) is uncommon. It may, however, become functionally leaky as a result of back pressure in mitral valve disease.

How is the diagnosis of a valvular disease established?   Top  

A thorough medical examination of the patient is often sufficient. Changes in the heart sound and the introduction of specific heart murmurs caused by turbulent blood flow are audible as the physician listens to the heart. The signs of heart failure can also be read by him.

A chest X-ray and an electrocardiogram are the simplest of investigations that must be first gone through. They help by providing further details.

But for finer information, the technique of echocardiogra­phy comes in useful. Its more recent refinement, trans-oeso-­phageal echocardiography, is perhaps the best in imaging the heart valves and the effect of disease on cardiac chambers.

In smaller towns, where facilities for echocardiography do not exist, a barium swallow X-ray investigation can prove helpful.

What is the treatment of rheumatic heart disease?   Top  

The medical treatment of rheumatic heart disease is essentially targeted at the control of disease and relief of symptoms. Cure is not possible.

In all patients, a monthly intramuscular injection of long-­acting (Benzedrine) penicillin is advisable. This prevents recur­rence of rheumatic fever and thus, possibly, restricts the run­away progression of the disease. In patients who are sensitive to penicillin, sulpha drugs can be substituted.

These measures are wholly preventive and have no bearing on the existing disease.

To bring relief to patients who show symptoms of the dis­ease, restriction of physical activity, reduced salt intake, main­tenance doses of oral diuretics (which increase urination and reduce fluid load on the body) and digitalis medication is often advocated. In aortic stenosis, angina may be relieved by taking nitroglycerine tablets. If the risk of blood clot formation exists, as in mitral stenosis and regurgitation, anti-coagulant medica­tion is necessary. Patients, who go into more severe forms of heart failure, require immediate hospitalization. Shots of diu­retics, digitalization of the heart, and oxygen inhalation may save the day for them.

But on the final count, at some .stage or the other, surgical remedial measures have to be considered.

Are there any steps which can help prevent rheumatic heart disease?   Top  

This needs a conscious effort on the part of the community. All throat infections, particularly in school-going children, need to be treated on a war footing. Early and adequate treatment with penicillin or erythromycin of all group A strep­tococci throat infections would not only help the individual but also check the spread of the disease within the community. This would prevent attacks of rheumatic fever and all its attendant complications. Mass education programmes and easy availability of treatment can go a long way to make this possible. The remarkable reduction in the incidence of rheu­matic fever in the developed countries is an ample pointer to the success of this strategy. But success in this prevention programme would also require a basic improvement in socio­economic conditions of the people-bigger and better homes to prevent overcrowding, better nutrition, and education.

Side. by side, it should be mandatory to treat all cases of rheumatic fever carefully. Penicillin or rythromycin, and salicylates, and strict bed rest are absolutely essential. The return to activity should be gradual and the child should never be rushed back to school or work.

In individuals, who have suffered an attack of rheumatic fever, necessary steps should be taken to prevent recurrences. This requires monthly shots ofbenzathine penicillin at least till the age of 35 years.

Herbal Cure for Heart - Complete Pack
Total Heart Support	Arjuna	Arjun Tea	Arjun Saar	Kumari Saar	Total Price
					Free Shipping and Handling Worldwide! No Side Effects!
2 Bottles	1 Bottle	1 Pack	4 Bottles	4 Bottles
$47.90	$ 31.00	$ 14.95	$ 75.80	$ 75.80	$ 274.55
Price after Discount 20%					$ 220.00
Buy This Pack for Just $ 220.00
Free Shipping and Handling Worldwide! No Side Effects!

Click here to buy Individual herbal products for heart care, heart herbal cure, herbs for heart