The primary affliction felt by patients of rheumatic fever is extreme inflammation of tissues, particularly the heart. Even after the disease has been eradicated from the body, the long-term effects of the inflammation can have a severe impact on a patient's health. Most commonly, the mitral valve between the two left chambers of the heart is damaged. However, other parts of the organ also can be afflicted. The majority of these conditions are similar to the problems associated with congenital heart disease.
Heart Muscle Damage
Among the most common complications of rheumatic fever, inflammation caused by the disease can simply lead to overall muscular damage of the heart. In the most basic sense, the organ's tissues are stretched beyond cohesiveness, even causing damage to the cells themselves. This causes the organ to weaken significantly, directly impacting the ability to perform its pumping function. The impact of this can lead to various types of conditions, from simple fatigue to the early onset of heart disease. Unfortunately, this damage cannot be repaired and will directly impact the continued health of the victim.
One of the major complications of rheumatic fever is known as valve stenosis. After suffering from the disease, the valve can have problems supporting proper blood flow, usually caused by a failure of the valve to open properly. When the aortic valve is compromised, the blood flowing from the left ventricle to the aorta is impeded. Likewise, pulmonary valve stenosis impacts the flow of blood from the right ventricle. When this occurs, the transfer of blood from the heart to the lungs is reduced, potentially causing lung failure.
Rheumatic fever can also lead to a condition known as valve regurgitation. Essentially, this is some form of leak caused by the failure of tissue after severe swelling. In most cases this causes the blood to flow in the wrong direction through the heart and vessels. When the aortic valve suffers from a leak, the reverse flow of blood from the aorta to the left ventricle can cause left ventricular hypertrophy. Other complications of rheumatic fever can also lead to problems with the mitral valve, such as creating a condition in which it fails to close properly. As the left ventricle contracts, blood leaks through the mitral valve and into the left atrium.
Oftentimes, the damage to the upper chambers of the heart are more prevalent than the lower chambers. This causes a condition known as atrial fibrillation, essentially the abnormal beating of the heart. The rhythm of the atria can become chaotic and irregular. Generally, atrial fibrillation does not cause death, but it does have a number of side effects that may impact the patient for the rest of his or her life. People suffering from irregular heartbeats often experience palpitations, chest pain and are subject to fainting spells. However, the risk of congestive heart failure and stroke are increased roughly seven times that of people without atrial fibrillation.
When the complications of rheumatic fever become too drastic, patients can simply suffer from heart failure. This is ultimately caused by the swelling of too much of the heart for blood to flow properly through the organ to other parts of the body. The process can be very slow and doctors often recognize the symptoms before life-threatening damage can be done.
Mayo Clinic: https://www.mayoclinic.com/health/rheumatic-fever/DS00250/DSECTION=complications
Wrong Diagnosis: https://www.wrongdiagnosis.com/r/rheumatic_fever/complic.htm
Rheumatic Heart Disease (Supplied by the Centers for Disease Control and Prevention; Public Domain; https://upload.wikimedia.org/wikipedia/commons/9/97/Rheumatic_heart_disease%2C_gross_pathology_20G0013_lores.jpg)