rheumatic heart disease

Rheumatic heart disease (RHD) is a common type of heart disease, which is a cardiac pathological change caused by rheumatic fever activity involving the heart valves, manifested as valvular stenosis or valvular insufficiency, with a higher prevalence in females than in males. The most commonly affected valve is the mitral valve, and multiple valves may also be involved simultaneously, referred to as combined valvular disease. According to incomplete statistics from the World Health Organization, there are over 15 million patients with rheumatic heart disease worldwide, and 500,000 new cases of acute rheumatic fever occur each year. The main cause is infection with Group A hemolytic streptococcus, and it is classified as an autoimmune disease. It frequently occurs in winter and spring, in cold and damp environments, with the initial onset age typically in young adults. The incidence of rheumatic valvular heart disease involving different heart valves varies. Research findings indicate that the mitral valve is involved in 100% of cases, of which isolated mitral valve disease accounts for 46.7%, the highest proportion, followed by mitral valve combined with aortic valve involvement, isolated aortic valve disease, tricuspid valve, and pulmonary valve disease. The pathological changes primarily involve edema and exudation at the margins and bases of the valves, gradually spreading to the entire valve, and even involving the chordae tendineae and papillary muscles, resulting in fusion of the valve leaflets at the commissural areas, fusion and shortening of the chordae tendineae, as well as fibrosis, stiffness, curling, and calcification of the valve leaflets, thereby leading to valvular stenosis or insufficiency. Rheumatic heart disease with complex causes can lead to severe complications; therefore, patients should actively cooperate with their doctors in a timely manner for treatment to avoid more serious consequences.