Rheumatic heart disease can lead to several severe complications. Key complications include:

* Heart Failure: Severely narrowed or leaking heart valves, caused by rheumatic fever, can impair the heart's ability to pump blood effectively, leading to heart failure.
* Bacterial Endocarditis: This is an infection of the inner lining of the heart. Heart valves damaged by rheumatic fever become particularly vulnerable to this type of infection.

Additionally, there are special considerations for women with rheumatic valvular disease. Before planning pregnancy, women should consult extensively with their treating physicians to develop a comprehensive plan, taking into account the extent of valve damage.