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The Strep Throat Link to Rheumatic Heart Disease

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Caused by the group A streptococcus bacteria, also known as Streptococcus pyogenes, strep throat leaves its victims with sore throat pain that ranks about 197 on a scale of one to ten, along with fever, headaches, fatigue, swollen neck lymph glands, rash, and of course, difficulty swallowing. Who can swallow when you’re in that much pain, anyway?

It’s also known to cause swollen and inflamed tonsils, red spots on the roof of the mouth, and even some pretty upset stomachs and vomiting -- which is certainly not fun when your throat already feels like a mix of sandpaper and hot lava.

While strep throat can -- and does -- occur at any age, strep throat is extremely contagious and very common in children between the ages of five and fifteen.

Chances are that you either know someone who’s had strep throat or you have first-hand knowledge and experience regarding this not-so-wonderful little throat infection and its side effects can be. What you may not know, is that strep throat can lead to some rather serious health complications, including inflammation of the kidneys and rheumatic fever.

Rheumatic fever may lead to a serious heart condition referred to as rheumatic heart disease.

Since most sore throats aren’t caused by strep throat, it’s not uncommon to delay treatment, or once diagnosed, to fail to complete all of the prescribed doses of antibiotic. Even this writer has been guilty of holding back a couple of pills just in case I need them to knock out something else later.

While this is never a good idea, one of the unintended consequences of delaying or under treating strep throat is rheumatic fever. An inflammatory disease, rheumatic fever is caused by primarily by untreated, or inadequately treated, strep throat. While it’s less common, rheumatic fever may also be caused by scarlet fever.

Rheumatic fever causes inflammation. While symptoms may vary, rheumatic fever is characterized by fever, painful or tender joints, hot or red swollen joints, pain that migrates from joint to joint, chest pain, heart palpitations, shortness of breath, unusual fatigue, and a flat-raised rash.

According to the Mayo Clinic, persons with rheumatic fever may also experience “jerky, uncontrollable body movements” and “outbursts of unusual behavior, such as crying or inappropriate laughing.”

More importantly for heart health, rheumatic fever may lead to rheumatic heart disease, with the inflammation damaging the heart and heart valves. The resulting heart damage from rheumatic heart disease is permanent and has life-long consequences, including:

*Valve stenosis. Decreased blood flow due to narrowing of the heart valve; complications include heart failure, heart enlargement, blood clots, lung congestion, and atrial fibrillation; medications may be prescribed to lessen symptoms; valve repair or replacement required to treat mitral valve stenosis.

*Valve regurgitation. Blood flows in the wrong direction due to a leak in the valve; complications include heart failure, atrial fibrillation, endocarditis or infection of inner lining of the heart, and pulmonary hypertension or high blood pressure in lung arteries; medications may be prescribed to lessen symptoms; valve repair or replacement required.

Rheumatic heart disease may also result in permanent heart muscle damage, leaving the heart unable to pump adequate supplies of blood. Some people with rheumatic heart disease develop atrial fibrillation which affects the upper chambers of the heart causing irregular or out of sync heart beats. Another common complication from rheumatic heart disease is heart failure.

One of the easiest ways to prevent rheumatic heart disease is to prevent rheumatic fever. If you suspect strep throat, it’s important to not only seek medical attention early but to take the entire antibiotic as prescribed.

If strep throat is promptly -- and completely -- treated, it’s less common for rheumatic fever, along with its serious complications, to develop.


Rheumatic Fever. The Mayo Clinic. 21 Jan 2011. http://www.mayoclinic.com/health/rheumatic-fever/DS00250/DSECTION=complications

Strep Throat. The Mayo Clinic. 26 Jun 2010. http://www.mayoclinic.com/health/strep-throat/DS00260

Mitral Valve Stenosis. The Mayo Clinic. 15 Sept 2011. http://www.mayoclinic.com/health/mitral-valve-stenosis/DS00420

Mitral Valve Regurgitation. The Mayo Clinic. 15 Sept 2011. http://www.mayoclinic.com/health/mitral-valve-regurgitation/DS00421

Reviewed September 26, 2011
by Michele Blacksberg RN
Edited by Jody Smith

Add a Comment2 Comments

EmpowHER Guest

The reason strep throat is contagious is because GAS bacteria live in your throat and nose making it easily for them to spread to other uninfected people around you. The bacteria travel through small droplets of water, which are released out when you sneeze or cough. As the droplets are sneezed out, they carry the infectious bacteria and land on any surface they find. If you touch any surface which has the bacterial droplets on them and then touch your nose or mouth with your contaminated hands, the infection then starts spreading in you. Similarly, if you share a glass or plate with the infected person or shake their hands, there is a high chance that you may become infected as well. It is best to wash your hands after such occasionsfollowing casual contacts. As mentioned earlier, the bacteria GAS is responsible for causing strep throat, but the Streptococcus class of bacteria also causes impetigo, an infection which causes red sores all over the body, rheumatic fever in addition to some more. The bacteria start growing in the throat or skin which leads to pus formation and non-inflammatory continuation of previous infection. Impetigo is contagious while rheumatic fever is not contagious however, strep throat can come before it, which certainly is contagious. At some times, if you touch skin sores caused by GAS, like impetigo, you can become infected easily. It is again recommended that you wash your hands. Sometimes you can become infected from food that contains the GAS bacteria. Although it does not happen often, strep throat is foodborne as well. That is why before pasteurization, preservation and refrigeration of food was not common, strep throat spread quite commonly. In the past, outbreaks of strep throat used to happen quite commonly due to contamination and consumption of raw milk. But now foodborne strep throat is rare so if many people complain of strep throat after eating food together in a venue, it can indicate contaminated food. When it comes to strep throat, the bacteria starts infecting by colonizing in the throat. The bacteria adheres to the dermal epithelial cells which is due to a specific bacterial surface ligand binding with receptors in the throat. The strong adherence is one of the reasons strep throat cannot be simply washed away so easily. In fact, salivary fluid and mucous passing down the throat cannot scrape the bacteria strongly adhered to the skin of the throat so they continue damaging the tissues in the throat. Previous infections are also crucial as any exposure before leads to weakening of the dermal barriers so when strep throat happens again, the bacteria are able to adhere to the host cells quite easily. Studies have also shown that at certain sites, the other bacteria are in competition with the infectious cells for adherence to the host cells.
Reference: http://bit.ly/2h220pC

December 6, 2016 - 1:31pm
EmpowHER Guest

This article was very informative. I suffer from mitral valve prolapse, with regurgitation, along with other heart disorders. I did not develop the condition until after I had strep so frequently and severely in my 20's that my tonsils were removed at 22. I used to get strep every other month, and was resistant to antibiotics due to the frequency of the infection. Being poor back then, I was never informed of the heart risk, and didn't find relief until a surgeon offered to remove the tonsils pro bono. Thanks for this article! Knowledge is power, and I'm glad to know where the ailment most likely came from.

February 19, 2016 - 8:04am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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