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Just diagnosed? RHD

Finding out you have RHD can be a worrying time. It is normal to have lots of questions about RHD and what it means to you. Answers to some common questions are listed below, others that you may need to ask your doctor are at the bottom of this page

How does the heart work?

  • The heart pumps blood around the body with each beat. Blood moves around the body and the four chambers of the heart. There are four valves in the heart which open and close while the heart pumps to help move blood in the right direction. The four heart valves are
  • The mitral valve - between the left atrium and the left ventricle.
  • The tricuspid valve - between the right atrium and the right ventricle.
  • The pulmonary valve - between the right ventricle and the pulmonary artery (the main artery that takes blood from the heart to the lungs to collect oxygen).
  • The aortic valve - between the left ventricle and the aorta (the main artery that takes oxygen-rich blood from the heart to the body).

What is RHD?

RHD is damage and scarring of the valves of the heart caused by an abnormal reaction to strep infections. The mitral valve is most commonly damaged by RHD. Heart valves can be damaged in a number of ways by RHD, most often regurgitation or stenosis.

Common valve lesions in RHD



(Stretching or incomplete closure of the heart valve)


(narrowing or tightening of the heart valve)

Mitral Valve

Valve between the left atrium and the left ventricle. The mitral valve is the most commonly affected in RHD. Approximately 90% of people with RHD have mitral valve involvement.

Mitral regurgitation the mitral valve does not close properly, causing backflow of blood from the left atrium to the left ventricle. Mitral regurgitation is the most common manifestation of RHD, particularly in young people.

Mitral stenosis may develop in more advanced RHD and is often caused by persistent or recurrent inflammation of the mitral valve.

Aortic Valve

Valve between the left ventricle and the aorta

Aortic regurgitation occurs when the aortic valve does not close properly. Aortic regurgitation generally causes left sided heart failure.


Narrowing and scarring of the aortic valve can cause obstruction to left ventricular outflow. RHD is a rare cause of aortic stenosis.

Tricuspid Valve

Rarely, RHD can cause isolated damage to the tricuspid valve, generally regurgitation.

How can RHD make me sick?

Damaged heart valves mean the heart cannot work normally. This may mean the heart does not pump effectively, causing heart failure. People with heart failure may feel tired and short of breath and experience swelling of the body. It can also cause the heart to beat irregularly (arrhythmia) or the valves of the heart to be infected (infective endocarditis). RHD may increase the risk of blood clots from the heart travelling to the brain causing a stroke. Women with RHD can have heart problems during pregnancy.

Why does my doctor say I have RHD even thought I feel healthy?

Doctors may be able to detect heart valve damage from RHD by listening to the heart or by heart scans before you begin to feel unwell. Early diagnosis of RHD is a good opportunity to begin treatment and stop RHD getting worse and making you feel sick.

How is RHD treated?

In most cases damage to the heart valves is permanent. The goal of treatment is to prevent any more damage occurring to heart valves and to manage any complications of RHD. This may involve different kinds of medication

Medications for heart failure

These medicines are usually diuretics and work by making your kidneys produce more urine to reduce the amount of fluid in your body. Tablets are usually used, some people may need to go to hospital to have these medicines through a drip into a vein.

Medications for arrhythmia

Some medications are used to help keep the heart beating in a more normal rate and rhythm.

Anticoagulation medicines

Some people with RHD are at increased risk of blood clots forming in the heart. You may need anticoagulation medicine to reduce this risk – read more in the anticoagulation section.

It may be helpful to write a list of questions to ask your doctor or specialist. Questions may include:

  • Do I need to be on long term antibiotics (secondary prophylaxis) to reduce the risk of having ARF?
  • Do I need a heart scan to check my heart? When should I have that?
  • Do I need to take extra antibiotics (antibiotic prophylaxis) when I go to the dentist?
  • What do I need to do if I am pregnant or plan to become pregnant?
  • What symptoms should I watch out for? Where should I go if I am worried about my RHD?
  • What should I do if I have a sore throat? What should I do if I have joint pain?