Rheumatic fever is a complication of a bacterial infection triggered by an atypical immune response. Rheumatic heart disease is a complication of rheumatic fever characterized by damage to the valves in your heart.

Rheumatic fever is a complication of strep throat due to group A streptococcus bacterial infection, which can cause:

  • strep throat
  • scarlet fever
  • impetigo

Rheumatic heart disease is damage to your heart valves caused by rheumatic fever. Damage to these valves can cause serious heart difficulties that might not appear for decades.

Read on to learn more about the differences between rheumatic fever and heart disease.

Here’s a look at the potential symptoms of rheumatic heart disease and rheumatic fever.

Rheumatic fever symptoms

Rheumatic fever symptoms usually appear 1–5 weeks after strep throat. They can include:

  • a high fever
  • painful and swollen joints, most commonly in your:
    • knees
    • elbows
    • wrists
  • fatigue
  • months later, jerky and uncontrolled movements called chorea in your:
    • hands
    • feet
    • face
  • heart murmur
  • painless bumps under your skin that form over bones or tendons
  • a rash with pink rings and a clear center that spreads outward (the skin discoloration may appear as another color on darker skin)

Rheumatic heart disease symptoms

About 50–70% of people with rheumatic fever develop carditis, which is inflammation of your heart. Carditis can lead to inflammation and damage to the valves in your heart that help channel blood through its different chambers and your bloodstream.

Rheumatic heart disease can cause symptoms like:

Here’s a look at the causes of rheumatic heart disease and fever.

Rheumatic fever causes and risk factors

Rheumatic fever is a complication of group A streptococcus bacterial infections. If these infections aren’t treated properly, they can trigger an atypical immune response that leads to the development of inflammation throughout your body and damage to healthy tissue.

The most common infection that leads to rheumatic fever is strep throat. It’s most common in children between the ages of 5–15.

Rheumatic fever and heart disease are large causes of premature death in developing countries but are less common in the United States. In the U.S., rheumatic fever develops in about 1 in 10,000 people per year compared to about 1 in 1,960 in India.

Risk factors for the development of rheumatic fever include:

  • household crowding
  • bed sharing
  • poor housing conditions
  • poverty
  • poor access to healthcare

Rheumatic heart disease causes and risk factors

Rheumatic heart disease is a complication of rheumatic fever that develops when the triggered immune reaction damages your heart valves. Heart damage usually occurs about 3 weeks after infection.

Rheumatic heart disease can develop from a single or repeated case of rheumatic fever.

It’s important to visit a doctor if you believe you might have strep throat because antibiotics are the most effective treatment. Without antibiotics, you’re at a higher risk of developing rheumatic fever.

Warning symptoms of strep throat include:

  • fever
  • pain when swallowing
  • red and swollen tonsils
  • white patches or pus on your tonsils
  • swollen lymph nodes in your neck

Learn more about strep throat symptoms.

Doctors don’t use any single test to diagnose rheumatic heart disease or fever. Some of the tests you may receive include:

  • a throat swab to look for group A streptococcus infection
  • a blood test to look for antibiotics suggestive of recent strep infection and to look for increased inflammation
  • electrocardiogram
  • echocardiography

Here are some of the treatment options for rheumatic heart disease and fever.

Rheumatic fever treatment

Doctors treat rheumatic fever with:

  • antibiotics to treat current bacterial infection
  • medications to lower your fever
  • medication to reduce inflammation or pain

If you’ve received a diagnosis of rheumatic fever, you may receive penicillin injections every 3–4 weeks to prevent recurrent episodes that might cause further damage to your heart or joints.

Rheumatic heart disease treatment

Rheumatic heart disease doesn’t have a cure. It may cause heart failure and require medications to treat it, such as:

If the valve is severely affected, you may require valve surgery, such as a replacement or repair.

The best way to prevent rheumatic heart disease or rheumatic fever is to prevent strep throat or receive prompt treatment if you have strep throat.

Preventive steps you can take include:

  • treating strep throat infections with antibiotics
  • taking preventive antibiotics if you’ve had recurrent rheumatic fever
  • washing your hands regularly and before touching your mouth, nose, or eyes
  • keeping hand sanitizer with you when you can’t wash your hands
  • avoiding sharing utensils with or contacting the saliva of people with a strep throat infection

Learn more about preventing strep throat.

Here are some frequently asked questions that people have about rheumatic heart disease and rheumatic fever.

How long does it take for rheumatic fever to affect the heart?

Rheumatic fever usually develops about 3 weeks after a strep throat infection. Symptoms of valve damage caused by rheumatic heart disease might not appear for years.

How long can you live with rheumatic heart disease?

It may take 2–3 decades for symptoms of rheumatic heart disease to appear. Some people never develop difficulties, although it’s a major cause of cardiovascular death in young adults, especially in developing countries with limited healthcare. It leads to about 200,000–250,000 premature deaths each year.

The best way to prevent both rheumatic fever and rheumatic heart disease is by treating strep throat promptly with antibiotics and taking steps to avoid contacting the bacteria that causes strep throat, such as washing your hands regularly.