Chronic rheumatic heart disease may not display any symptoms for up to 50 years after the initial bout of rheumatic fever. After the initial fever, the antibodies produced by the sufferer to the streptococcus infection attack the heart valves, causing scarring and stiffness.
The damage can affect either valve of the left ventricle - the mitral valve, which prevents blood flowing back into the atrium, or the aortic valve, which guards the exit from the left ventricle into the aorta (the main artery of the body). If the valves become so stiff that the blood has difficulty driving past them, they are said to be suffering from mitral or aortic stenosis (narrowing of the valves). However, if they cannot close at all, some of the blood will start to flow the wrong way, at which point they are said to have mitral incompetence (also known as mitral regurgitation) or aortic incompetence (also known as aortic insufficiency).
Symptoms of Mitral Stenosis
- shortness of breath
- palpitations
- frequent bronchitis
- cold hands and feet
- spitting blood
- constant tiredness
Symptoms of Mitral Incompetence
As above, plus the following:
- high colour over the cheek bones
- increased shortness of breath
Symptoms of Aortic Stenosis and Incompetence
Sufferers of aortic stenosis may remain symptomless until old age. However, some people may experience shortness of breath, chest pains with exercise (angina) and fainting fits. These symptoms worsen with aortic incompetence.
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