Rheumatic Heart Disease (RHD) is a leading yet preventable cause of heart failure and long-term disability across Australia. It is highly prevalent among Aboriginal and Torres Strait Islander communities, especially in remote and regional areas where access to healthcare, housing, and essential services can be challenging. Globally, it remains the most commonly acquired heart disease in young people.

RHD begins with a Strep A infection, most commonly in the throat (known as strep throat or streptococcal pharyngitis), but it can also occur on the skin (such as impetigo). Without timely treatment, Strep A infections can lead to Acute Rheumatic Fever (ARF), an autoimmune inflammatory reaction. ARF can ultimately scar the heart valves, resulting in mild to severe rheumatic heart disease.

The positive news is that many cases of RHD can be prevented through early detection and appropriate medical care.

This article outlines 10 practical, evidence-based steps that may help reduce the risk of rheumatic heart disease, along with how certain heart health assessments in the Everlab longevity program can support your heart health objectives.

The 10 Rheumatic Heart Disease Prevention Steps

1. Treat Sore Throats and Skin Sores Promptly

Most rheumatic heart disease cases in Australia’s high-risk populations begin with a Strep A skin infection (pyoderma) or an untreated strep throat caused by Streptococcus pyogenes.

Just one untreated streptococcal infection can lead to Acute Rheumatic Fever, which may later contribute to heart valve damage. This is why primary prevention is essential.

If you are experiencing a sore throat or an upper respiratory infection, see your GP for assessment, which may include a throat swab. Also, do not ignore cuts, insect bites, or skin sores. Clean them well, and allow a healthcare professional to determine whether treatment, including topical or oral antibiotics, is required.

Managing skin sores effectively is one of the strongest primary prevention strategies for reducing the risk of rheumatic fever.

2. Recognise Symptoms of Acute Rheumatic Fever (ARF) Early

Knowing the symptoms of ARF helps you act quickly. Symptoms may include:

• Fever, painful joints, and joint swelling
• Involuntary, rapid movements (Sydenham’s chorea)
• Rash (erythema marginatum) or small, painless bumps
• Chest discomfort, shortness of breath, fatigue, or breathing difficulties (which may reflect inflammation affecting the heart)

If these symptoms appear, especially following a recent throat or skin infection, seek medical advice. Early diagnosis and management of ARF can help reduce the risk of RHD developing or progressing.

3. Complete Prescribed Courses of Antibiotics

Stopping antibiotics early increases the risk of reinfection and recurrence of Acute Rheumatic Fever.

Individuals diagnosed with ARF or RHD may require long-term preventative antibiotics as secondary prophylaxis. This commonly involves Benzathine Penicillin G (BPG) injections. Your GP will guide treatment to help reduce the risk of future Strep A infections, which may otherwise cause further episodes of ARF and additional heart damage.

4. Get Regular Heart Imaging (Echocardiography)

An echocardiogram is one of the most effective tools for assessing heart valve function and identifying early signs of damage caused by ARF.

Many high-risk communities in Australia run screening programs using portable echocardiography to detect mild RHD in young people who may never have had obvious ARF symptoms.

People living with established RHD often require regular echocardiograms to monitor changes over time, particularly in the heart valves.

5. Practise Good Hygiene and Improve Living Conditions

Reducing exposure to Strep A bacteria is a key primary prevention strategy.

You can help reduce transmission by:

• Washing hands regularly
• Avoiding sharing cups or utensils
• Sneezing or coughing into your elbow
• Addressing skin infections promptly

Improving housing conditions and reducing overcrowding, where possible, also contribute to lowering the spread of Strep A infections within communities.

6. Eat Well to Support Your Immune System

A healthy diet supports immune function and overall heart health.

Aim to include:

• Lean protein for tissue repair
• Foods high in omega-3 fats (salmon, walnuts)
• Whole grains and legumes for sustained energy
• Meals lower in added salt and sugar

A well-balanced diet can support your immune system and help your body respond more effectively to infections that may contribute to ARF.

7. Schedule Routine Medical Appointments for Children

Children aged 5 to 14 have the highest risk for ARF and RHD. Regular medical check-ups help ensure throat or skin infections are treated early, and that any early signs of heart involvement (such as a murmur) are identified.

If your child experiences recurring strep infections or if RHD is common in your community, speak with your local health provider about primary prevention options.

8. Manage Other Cardiovascular Risk Factors

Conditions such as high blood pressure, diabetes, and obesity can worsen outcomes for people with RHD by increasing the risk of complications such as heart failure or atrial fibrillation.

Managing these conditions through lifestyle changes, regular monitoring, and medical care helps support overall heart function for people with existing RHD.

9. Stay Active

Regular physical activity improves circulation, heart strength, and immune function.

Aim for:

• 150–300 minutes of moderate-intensity activity per week, or
• 75 minutes of vigorous activity per week, plus
• Muscle-strengthening exercises on two days per week

If you have severe RHD, consult your doctor about safe activity levels.

Even small amounts of movement help. If you are just starting, begin with a few minutes each day and gradually increase your activity.

10. Avoid Smoking

Smoking does not directly cause RHD, but it increases infection risk and promotes inflammation. It also contributes to cardiovascular complications, including valve deterioration, bacterial endocarditis, and clot formation.

Quitting smoking is an important step in protecting long-term heart health.

Final Thoughts: Prevention Is Within Reach

Rheumatic heart disease is a serious but, in many cases, preventable condition. Prevention in Australia relies on two key strategies:

• awareness, early detection, and regular monitoring
• prompt treatment of Strep A infections

Everlab offers a range of diagnostic and wellness tests, including screening options that can support discussions with your doctor about heart health and infection risk. These tests do not diagnose RHD but can offer useful evaluation of risk factors for you and your healthcare provider.

Sources

1. ‍1.06 Acute rheumatic fever and rheumatic heart disease - Australian Government
2. ‍WHO guideline on the prevention and diagnosis of rheumatic fever and rheumatic heart disease- WHO
3. ‍Acute rheumatic fever and rheumatic heart disease in Australia- Australian Government

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