Rheumatic Heart Disease
Also written as RHD.
Rheumatic heart disease is a disease of older children and follows streptococcal infection.
RHEUMATIC HEART DISEASE
- Cause: Group A Strep pharyngitis → autoimmune cross-reaction (type II/III hypersensitivity)
- Anti-streptolysin O (ASO) antibodies cross-react with cardiac tissue
- Aschoff bodies — pathognomonic granulomas with Anitschkow cells (caterpillar cells)
- Jones Criteria (major): Carditis, Polyarthritis, Chorea, Erythema marginatum, Subcutaneous nodules
- Most common valve affected: Mitral Aortic Tricuspid
Read this in Comprehensive Heart Pathology Notes 🫀
Rheumatic Heart Disease
- Rheumatic heart disease develops following Group A Strep pharyngitis due to an autoimmune cross-reaction via molecular mimicry . Pathognomonic findings include Aschoff bodies containing Anitschkow cells (also known as caterpillar cells). Th
Read this in Heart Pathology: Comprehensive Short Notes
What our notes say
- Rheumatic heart disease is a disease of older children and follows streptococcal infection. (Paediatrics end of first trimester exam (MBPE 4300): 27 November 2018, 49 of 50 )
- The valves most commonly affected in rheumatic heart disease are: (Paediatrics end of second semester exam (MBPE 4300): 4 October 2022, cardiology,)
- In many low- and middle-income countries, including Kenya, rheumatic heart disease is the leading cause of valve disease in young people. (Heart murmurs)
- Rheumatic heart disease is the commonest cause of valve disease in young people across much of Africa and Asia.* (Acute rheumatic fever and rheumatic heart disease)
- Pre-existing valve disease (rheumatic heart disease, congenital defects), prosthetic valves, previous endocarditis, intravenous drug use, indwelling lines, dental or other procedures with bacteraemia, immunosuppression and HIV. (Junior Clerkship in Internal Medicine (MBIM4100) main exam, Paper One: 31 Januar)
- The commonest valve involved in acute rheumatic fever and rheumatic heart disease: (Internal Medicine (MBIM 4100) main exam, Paper One: 3 July 2019)
Study material on Rheumatic Heart Disease
- Acute rheumatic fever and rheumatic heart disease
- 🫀 VALVULAR HEART DISEASE — ULTRA DEEP NOTES
- Heart Pathology: Comprehensive Short Notes
- Medical Pathology Final Revision: Chemical, Hema, Systemic
- Comprehensive Heart Pathology Notes 🫀
- CARDIOVASCULAR PATHOLOGY
- CARDIOVASCULAR PATHOLOGY
- Essential Cardiovascular Pathology: Atherosclerosis to Endoc
- Cardiovascular & Respiratory Pathology: Atherosclerosis, RHD & MI Review
- Cardiovascular, Respiratory & GI/Hepatobiliary Pathology Revision (MBPA 3500 Paper 2)
Images
Practice questions on Rheumatic Heart Disease
A 24-year-old woman with rheumatic heart disease receives a porcine bioprosthesis. After 10 years it needs replacement. Most likely pathologic finding?
- Dehiscence
- Endocarditis
- Strut failure
- Calcification
Answer: D. Bioprosthetic valves avoid anticoagulation but undergo progressive calcification over 5–10 years, causing stenosis and requiring replacement. ---
Which of the listed below is LEAST commonly affected in Rheumatic heart disease?
- Mitral Valve
- Tricuspid Valve
- Mitral and Aortic valve
- Aortic Valve
- Pulmonary Valve ✅ Answer: E
Answer: A. The pulmonary valve is the least commonly affected valve in rheumatic heart disease, which predominantly affects the mitral and aortic valves.