D2I2.
infection⚑ High burden in India

Rheumatic heart disease

fever (RF) is an disease that can involve the heart, joints, skin, and brain. The disease typically develops two to four weeks after a throat . Signs and symptoms include fever, multiple painful joints, involuntary muscle movements, and occasionally a characteristic non-itchy rash known as marginatum. The heart is involved in about half of cases. Damage to the heart valves, known as rheumatic heart disease (RHD), usually occurs after repeated attacks but can sometimes occur after one. The damaged valves may result in heart failure, and infection of the valves.

Underlined words are explained — tap any of them.

Symptoms — what it feels like

  • ·Fever, multiple painful joints, involuntary muscle movements, marginatum

Causes — why it happens

  • · disease triggered by strains of

How it's found

  • ·Based on symptoms and history

Prevention

  • ·Prompt for , improved sanitation

Treatment

  • ·Prolonged periods of , valve replacement , valve repair

Complications

  • · heart disease, heart failure, , of the valves

The sections below are general education drawn from public guidelines (NHS, Mayo, CPIC, WHO, ICMR). They are not individually reviewed by a clinician and are not medical advice — always talk to a doctor about your own health.

For clinicians · pharmacogenomics

Genes that change how certain drugs work — and that differ in South Asians. This is education, not a dosing tool; genotype-guided prescribing is a clinician decision.

CYP2C9 + VKORC1Warfarin
CPIC A

is famously hard to dose - too little and form, too much and you bleed. Two genes largely decide how much each person needs: one controls how fast you break the drug down, the other how strongly it works. Knowing them helps a doctor get closer to the right dose sooner.

South Asian signal: CYP2C9 and VKORC1 variants together explain up to ~18% and ~30% of warfarin-dose variance respectively in Europeans, but explain proportionally less in Asian ancestry, so ancestry-specific algorithms matter. CYP2C9 and VKORC1 variant frequencies differ across Indian sub-populations; CPIC therefore provides continental-ancestry-specific dosing guidance rather than a single formula (CPIC 2017 update).

Prescriber note: Where CYP2C9/VKORC1 genotype is available, use an ancestry-appropriate validated algorithm (e.g. the CPIC-endorsed approach) for the initial dose and then titrate to INR; do not apply European-derived dose predictions unmodified to South Asian patients. CPIC recommends using a validated pharmacogenetic dosing algorithm that incorporates CYP2C9 and VKORC1 (and, for some ancestries, CYP4F2 and rs12777823) to estimate a starting warfarin dose targeting INR 2-3, rather than a fixed empirical dose, when genotype is available.

Not a dosing tool. Genotype-guided prescribing is a clinician decision; genotyping access in India is limited.

Test yourself

0/4 answered

4 quick questions on Rheumatic heart disease. Tap an answer to check it.

1. Rheumatic fever usually develops a few weeks after which infection?
2. Rheumatic heart disease refers to damage to which part of the heart?
3. Rheumatic fever most often begins in people of which age group?
4. How can rheumatic fever often be prevented?
Plain-language summary adapted from Wikipedia. Not medical advice.