Rheumatic Fever

Rheumatic Fever (RF) is a complication of untreated strep throat or soft tissue infection (scarlet fever). Rheumatic fever is most common in 5 to 15 year old children. However, older children and adults have been known to contract it as well. Although strep throat is common, rheumatic fever is rare in the United States and other developed countries. However, RF remains common in many developing nations. If not treated, RF can cause permanent damage to the heart, including damaged heart valves and heart failure; therefore, proper treatment is warranted.

Causes of Rheumatic Fever

The exact cause of rheumatic fever is not yet known, but it occurs shortly after an infection with untreated group A streptococcus (the bacteria that causes "strep throat" and scarlet fever). Genetics are also said to play a role.

Symptoms of Rheumatic Fever

Rheumatic fever symptoms vary. You can have few symptoms or several, and symptoms can change during the course of the disease. The onset of RF usually occurs about two to four weeks after a strep throat infection. Signs and symptoms include:

  • Chest pain
  • Fatigue
  • Fever
  • Heart murmur
  • Heart arrhythmias
  • Jerky, uncontrollable body movements that occur most often in the hands, feet and face.
  • Outbursts of unusual behavior such as crying or inappropriate laughing.
  • Painful, red, swollen and tender joints most often in the knees, ankles, elbows and wrists.
  • Shortness of breath
  • Small, painless bumps beneath the skin

Diagnosis of Rheumatic Fever

Your doctor will ask questions about your symptoms and whether you know or suspect you have had a recent streptococcal infection. A physical examination will follow, giving particular attention to listening for any heart murmurs, checking the joints for pain and inflammation, and examining the skin for rashes or lumps. After that, you may have:

Diagnostic tests and procedures

Treatment of Rheumatic Fever

Treatment will involve getting rid of the residual group A bacteria and treating and controlling the symptoms. Treatment options include:

Lifestyle changes

  • Eat a heart-healthy diet
  • If you’re overweight, talk to your doctor about weight-loss options.
  • Limit physical activity until inflammation, pain and other symptoms have improved.
  • Manage stress
  • Make and keep appointments to see your doctor for routine check-ups and follow-up tests.


  • Antibiotics will help treat disease caused by bacteria.
  • Anti-inflammatory medications will help reduce inflammation and relief pain.
  • Anticonvulsant medications will help control or stop ongoing series of seizures.

Medical and surgical procedures