Overview:

• Caused by a strain of Streptococcus, specifically group A beta-hemolytic streptococcus.
• It is a complication that can follow untreated or poorly treated strep throat.
• The condition is more common in areas with limited access to healthcare and antibiotics but is less frequent in countries like Canada due to prompt treatment.

Pathogenesis:

• The initial infection is strep throat (upper respiratory tract infection).
• The bacteria enter the bloodstream and then travel to the heart.
• In rheumatic fever, antibodies develop against the strep bacteria.
  • These antibodies can cross-react with body tissues, particularly heart valves.
  • This autoimmune response leads to valvular damage and deterioration.

Progression if Untreated:

• Persistent infection leads to chronic rheumatic heart disease.
• Valve damage causes valvular stenosis or regurgitation.
• Long-term effects:
  • Permanent heart valve deterioration.
  • Possible heart failure and arrhythmias.

Treatment & Prevention:

• Antibiotics (e.g., penicillin):
  • To eliminate bacteria and prevent autoimmune complications.
• Early treatment of strep throat prevents progression to rheumatic fever.
• In Canada and similar countries, most strep throat cases are treated promptly, so rheumatic fever is rare.

Summary:

Rheumatic fever results from an autoimmune response triggered by group A streptococcal infection, with potential long-term damage to heart valves if untreated. Prompt antibiotic treatment of strep throat is critical for prevention.