Understanding Rheumatic Carditis: Symptoms, Causes and Care

Written by Medicover Team and Medically Reviewed by Dr Jagadeesh Chandra Bose Y , Cardiologists

Rheumatic carditis is inflammation of the heart that develops as a complication of rheumatic fever. It can affect the heart valves, heart muscle and the tissues surrounding the heart.

The condition usually develops after an abnormal immune response to an untreated or inadequately treated group A streptococcal infection. Severe or repeated inflammation can permanently damage the heart valves and lead to chronic rheumatic heart disease.

What Are the Types of Rheumatic Carditis?

Rheumatic carditis can vary according to the severity, duration and extent of heart involvement. The main types include:

What Are the Symptoms of Rheumatic Carditis?

Symptoms of rheumatic carditis depend on the severity of inflammation and the parts of the heart affected. Mild cases may cause few symptoms, while severe inflammation can interfere with the heart's ability to pump blood effectively.

What Causes Rheumatic Carditis?

Rheumatic carditis is caused by an abnormal immune response that can occur after an infection with group A Streptococcus bacteria. Instead of targeting only the infection, the immune system mistakenly attacks tissues in the heart.

Group A Streptococcal Infection

Rheumatic carditis most commonly develops after untreated or inadequately treated strep throat or scarlet fever.

Abnormal Immune Response

The immune system may mistakenly attack heart tissues after a streptococcal infection. This can cause inflammation of the heart valves, heart muscle and surrounding tissues.

Genetic Predisposition

Some people may have inherited factors that make them more likely to develop rheumatic fever and rheumatic carditis after a streptococcal infection.

Environmental Factors

Crowded living conditions, limited access to healthcare and delayed treatment of streptococcal infections can increase the risk of rheumatic fever and subsequent heart involvement.

When Should You See a Doctor for Rheumatic Carditis?

Medical evaluation by a Cardiologist is important after rheumatic fever or a recent streptococcal infection if symptoms affecting the heart develop. Early diagnosis and treatment can control inflammation, identify valve damage, and reduce the risk of long-term complications such as rheumatic heart disease.

You should see a doctor if you have:

Get medical help immediately if:

These could be signs of a serious complication like heart failure, which needs urgent care.

How Is Rheumatic Carditis Diagnosed?

Diagnosing rheumatic carditis involves reviewing symptoms, checking for evidence of a recent streptococcal infection and assessing the structure and function of the heart. Several tests may be used to confirm heart involvement.

Physical Examination

A healthcare provider listens for abnormal heart sounds, such as a heart murmur, and checks for signs of fluid retention, irregular heartbeat or heart failure.

Echocardiogram

An echocardiogram uses sound waves to assess the heart valves, chambers and pumping function. It can detect valve inflammation, leakage or other abnormalities associated with rheumatic carditis.

Electrocardiogram (ECG)

An ECG records the electrical activity of the heart and can identify abnormal rhythms or changes associated with inflammation.

Chest X-Ray

A chest X-ray may show an enlarged heart or fluid accumulation in the lungs in people with severe heart involvement.

Blood Tests

Blood tests may check for evidence of a recent streptococcal infection and measure inflammatory markers such as C-reactive protein and erythrocyte sedimentation rate.

How Is Rheumatic Carditis Treated?

Treatment for rheumatic carditis aims to eliminate any remaining streptococcal infection, reduce inflammation, relieve symptoms and prevent further heart damage. The treatment plan depends on the severity of carditis and the extent of valve involvement.

Antibiotics

Antibiotics are used to eliminate group A streptococcal bacteria. Long-term preventive antibiotics may also be recommended to reduce the risk of recurrent rheumatic fever and additional heart damage.

Anti-Inflammatory Medications

Anti-inflammatory medicines may be prescribed to reduce inflammation and relieve symptoms associated with rheumatic fever and carditis.

Corticosteroids

Corticosteroids may be considered in severe cases to control significant heart inflammation, particularly when heart function is affected.

Rest and Supportive Care

Rest may be recommended during the acute phase to reduce strain on the heart. Activity can usually be increased gradually as inflammation and symptoms improve.

Treatment for Heart Failure

People who develop heart failure may require medicines to reduce fluid buildup, improve heart function and control blood pressure.

Heart Valve Surgery

Severe or permanent valve damage may require surgical valve repair or replacement, particularly when the damaged valve significantly affects blood flow or heart function.

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What Are the Risk Factors for Rheumatic Carditis?

Factors that increase the risk of rheumatic fever can also increase the likelihood of developing rheumatic carditis. Important risk factors include:

What Are the Complications of Rheumatic Carditis?

Severe or recurrent rheumatic carditis can cause permanent damage to the heart, particularly the heart valves. Possible complications include:

Can Rheumatic Carditis Be Prevented?

Preventing rheumatic fever and recurrent streptococcal infections is the most effective way to reduce the risk of rheumatic carditis and long-term heart damage.