Many health experts question whether the risk
of age is more a reflection of cumulative variable
risks than itself an independent risk factor. Target-
ing individual risk factors early in life, before sub-
stantial cardiovascular disease develops, is the
most effective preventive measure. Once a cardio-
vascular condition begins, preventive efforts shift
focus to slow the progression of disease.
See alsoCALORIE; CARDIOVASCULAR DISEASE PREVEN-
TION; DIET AND CARDIOVASCULAR HEALTH; PHYSICAL
EXERCISE AND CARDIOVASCULAR HEALTH; SMOKING AND
CARDIOVASCULAR DISEASE.
rheumatic heart disease Damage to the valves of
the HEARTas a consequence of rheumatic FEVER,
which develops as a complication of untreated or
undertreated STREP THROAT. Streptococcal BACTERIA
attack the heart valves, most commonly the mitral
and aortic valves, which can leave them scarred
and deformed. Rheumatic fever and rheumatic
heart disease are now uncommon as ANTIBOTIC MED-
ICATIONSso successfully treat strep infections involv-
ing the THROAT. In the 1950s rheumatic heart
disease was the leading cardiovascular cause of dis-
ability and death among American adults. Today,
rheumatic heart disease is much less of a threat
though still affects about 2 million Americans each
year, about 3,500 of whom die as a result.
Signs of CARDIOVASCULAR DISEASE(CVD) that sug-
gest rheumatic heart disease may include clinically
significant HEART MURMURand other indications of
valvular insufficiency. Doctors may suspect rheu-
matic heart disease as the cause when there is a
recent history of sore throat or strep throat in
combination with symptoms that suggest autoim-
mune or inflammatory disease, such as inflamed
joints, and of cardiac insufficiency, such as DYSPNEA
(shortness of breath). The diagnostic path typically
includes ELECTROCARDIOGRAM(ECG) to evaluate any
arrhythmias, which are common in VALVULAR
HEART DISEASE.ECHOCARDIOGRAMor MAGNETIC RESO-
NANCE IMAGING(MRI) allows the cardiologist to visu-
alize and assess the heart’s valves, structure, and
function.
Treatment for rheumatic heart disease may
involve medications to treat secondary cardiovas-
cular conditions such as arrhythmias and HEART
FAILURE, and surgical repair or replacement of
damaged valves. People who have rheumatic
heart disease are vulnerable to subsequent infec-
tions and require ANTIBIOTIC PROPHYLAXIS before
invasive diagnostic and therapeutic procedures,
and with infections such as PHARYNGITIS, to prevent
ENDOCARDITIS.
See also AUTOIMMUNE DISORDERS;MEDICATIONS TO
TREAT CARDIOVASCULAR DISEASE; SCARLET FEVER.rheumatic heart disease 103