Rheumatic Fever
Rheumatic fever is, world-wide, the commonest cause of heart disease in children, though it is now rare in the Western World. It is caused by an abnormal immune response to infection by a bacterium called a Group A haemolytic streptococcus. This causes tonsillitis, and between 2 and 6 weeks after the throat infection susceptible children develop the disease. Besides a rash, arthritis flitting from one joint to another and possibly writhing movements of the limbs (called Sydenham’s Chorea or St. Vitus’ dance) which may last for months, there may be permanent damage to the heart. While any part of the heart - or all of it - can be affected, the most common damage is to the mitral valve, between the left atrium and the left ventricle, which may become narrowed or fail to close properly. This can cause breathlessness, irregular heart beats and the presence of small blood clots - called emboli - in the circulation: one of the causes of strokes. Treatment may be required to thin the blood.
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