Acute Rheumatic Fever: Symptoms, Risks, and Prevention

Acute rheumatic fever is a serious inflammatory condition that can affect multiple parts of the body, including the joints, heart, skin, and brain. It most often develops after an untreated or inadequately treated throat infection caused by group A streptococcus bacteria.

If acute rheumatic fever affects the heart, it can permanently damage the heart valves. This complication is known as rheumatic heart disease and can lead to long-term heart problems if not identified and managed early.

In Canada, acute rheumatic fever is uncommon but still occurs, particularly in children and youth who experience repeated or untreated strep throat infections.

What Are the Symptoms of Acute Rheumatic Fever?

Symptoms usually appear 2–4 weeks after a strep throat infection and can vary from mild to severe. An individual may experience one or more of the following:

• Fever

• Swollen, painful, or reddened joints (often moving from one joint to another)

• Chest pain or shortness of breath

• Rapid or irregular heartbeat

• Extreme tiredness or weakness

• Non-itchy rash

• Painless lumps under the skin

• Involuntary movements or twitching (more common in children)

Healthcare providers may detect a heart murmur when listening with a stethoscope, which can indicate heart involvement.

Who Is Most at Risk?

Acute rheumatic fever is more likely to occur in:

• Children between 5 and 14 years old

• Young adults

• Individuals with a history of acute rheumatic fever

• People who have repeated or untreated streptococcal throat infections

Why Early Treatment Matters

Without prompt treatment, acute rheumatic fever can cause permanent heart valve damage, increasing the risk of heart failure, stroke, and other complications later in life. Early recognition and proper medical care significantly reduce these risks.

Prevention and Long-Term Care

Preventing acute rheumatic fever starts with early treatment of strep throat using prescribed antibiotics.

For individuals who have already experienced acute rheumatic fever, long-term prevention is essential and may include:

• Regular antibiotic injections every 3–4 weeks to prevent recurrence

• Ongoing medical follow-ups to monitor heart health

• Good oral hygiene and routine dental care

• Annual influenza and pneumococcal vaccinations, as recommended by a healthcare provider

Preventive treatment often continues for 10 years or longer, depending on heart involvement and medical advice.

Management and Medical Treatment

Management focuses on reducing inflammation, controlling symptoms, and preventing complications. This may include:

• Antibiotics to eliminate remaining streptococcal bacteria

• Anti-inflammatory medications to relieve joint pain and fever

• Specialist care for individuals with rheumatic heart disease

• In severe cases, heart valve surgery

First Aid & Education Disclaimer

This information is provided for educational purposes only and is not a substitute for medical advice or diagnosis. Acute rheumatic fever is a medical condition that requires assessment and treatment by a healthcare professional.

Learning to recognize early signs of infection, fever, and cardiac distress is an important part of first aid awareness. To build confidence in recognizing and responding to medical emergencies, consider enrolling in a First Aid and CPR course with St. Mark James Training, Canada’s largest 100% Canadian-owned first aid and CPR training provider.