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Rheumatic Heart Disease Around the World (Including Your Clinic)

RHD is a disease of deprivation in that it occurs almost exclusively in individuals who lack reliable primary health care. Socioeconomic conditions leading to increased GAS exposure include household crowding, poor hygiene and poor access to medical care. It is often referred to as a disease of poverty and, indeed, the majority of cases are found in low-income countries.

But while RHD, and its antecedent rheumatic fever, has largely disappeared from wealthy countries, it is far from unheard of. Nor is it only immigrant cases that present to North American clinics.

"In the U.S., RHD is rare. Sometimes we see immigrants who present with RHD. But for anyone living in the U.S.…

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Featured

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Once a year, doctors travel to Rwanda to perform lifesaving surgery on people with damaged heart valves — a disease caused by untreated strep throat.

 Rheumatic Heart Disease: JACC Focus Seminar

It is a sad reality that although eminently preventable, and despite possessing such knowledge for >70 years, rheumatic heart disease (RHD) remains the most common cause of cardiovascular morbidity and early mortality in young people worldwide. A disease of the poor, RHD is one of the most neglected diseases. Several challenges are unique to the acute rheumatic fever/RHD continuum and contribute to its persistence, including its sequestration among the poorest, its protracted natural history, the erratic availability of penicillin, and the lack of a concerted effort in endemic regions.

Articles of Interest

'I'm too young to die': the disease of disadvantage forcing Indigenous children to have open-heart surgery

An entirely preventable condition called rheumatic heart disease is leaving Indigenous children with severe and irreversible heart damage.

A Boy Named Chance in a Land Without Heart Surgeons

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Acute Rheumatic Fever and Rheumatic Heart Disease

It is RHD that remains a significant worldwide cause of morbidity and mortality, particularly in resource-poor settings. While ARF and RHD were once common across all populations, improved living conditions and widespread treatment of superficial S. pyogenes infections have caused these diseases to become comparatively rare in wealthy areas. The development of ARF occurs approximately two weeks after S. pyogenes infection. The clinical manifestations and symptoms of ARF can be severe and are described in the Revised Jones Criteria

Breaking Down the Myths and Stigmas Surrounding Rheumatic Heart

Rheumatic heart disease (RHD) and rheumatic fever are often shrouded in myths and stigmas that lead to misunderstanding and inadequate care. One common myth is that rheumatic fever and rheumatic heart disease are diseases of the past or only occur in developed countries. In reality, they remain significant health problems, especially in developing countries and among indigenous populations, due to lack of access to healthcare and extreme poverty. Another misconception is that these conditions are contagious. They are not. Rheumatic fever develops from the body's response to a strep throat infection, not from direct person-to-person transmission. Stigma arises from misunderstandings about these diseases, leading to social isolation and psychological stress for those affected. People might mistakenly believe these conditions are due to poor personal hygiene or hereditary issues, which is not the case.

Contemporary Diagnosis and Management of Rheumatic Heart Disease: Implications for Closing the Gap

Rheumatic heart disease (RHD) has declined sharply in most industrialized, high-income nations and many other parts of the world that have had improvements in human development indices and health systems. The disease persists among the rural poor and marginalized populations with little or no access to primary health care. There are many complex reasons for this ongoing global disparity, including inadequate and inaccurate data on disease burden, ineffective advocacy, ongoing poverty and inequality, and weak health systems, most of which predominantly affect large populations in most low- and middle- income countries.

D.C. Doctor Working to Save Mike, Other Ugandan Kids at Risk of Preventable Death

RHD once tormented our country, too. I’m proud to say that stomping it was among the first great feats by my organization, the American Heart Association. Dr. Beaton knew that and wanted to help do the same in Uganda.

Echocardiogram Screenings are Effective in Preventing Rheumatic Heart Disease

Routine screening with echocardiogram can detect three times as many cases of rheumatic heart disease (RHD) as clinical examinations, offering a novel approach in preventing this common disease...

Launch of “Heart on Your Sleeve” Social Media Campaign

The aim of the social media campaign is to raise awareness about acute rheumatic fever (ARF) and rheumatic heart disease (RHD) within the community at a ground level. Within Australia, Aboriginal and Torres Strait Islander people are almost twenty times more likely to die of RHD.

Medicine: Red Plague

The biggest killer of children between the ages of five and 15 is rheumatic heart disease. In one year it claims almost twice as many victims as infantile paralysis does in ten. Today, about 1,000,000 people have been left crippled by this insidious, recurring malady. Yet rheumatic heart disease, which smolders in slum districts and overcrowded tenements does not get a fraction of the publicity given to cancer or tuberculosis.

Recent Advances in the Rheumatic Fever and Rheumatic Heart Disease Continuum

Nearly a century after rheumatic fever (RF) and rheumatic heart disease (RHD) was eradicated from the developed world, the disease remains endemic in many low- and middle-income countries (LMICs), with grim health and socioeconomic impacts.

Rheumatic fever & rheumatic heart disease: The last 50 years

Rheumatic fever (RF) and rheumatic heart disease (RHD) continue to be a major health hazard in most developing countries as well as sporadically in developed economies.

Rheumatic fever & rheumatic heart disease: The last 50 years

Rheumatic fever (RF) and rheumatic heart disease (RHD) continue to be a major health hazard in most developing countries as well as sporadically in developed economies.

Rheumatic heart disease in Indigenous children could be spread by throat bacteria, researchers find

An entirely preventable condition leaving Indigenous children with severe and irreversible heart damage may be spread due to a reservoir of bacteria in the throat that causes no symptoms in the host, Australian researchers have found. It is a discovery that will likely have implications for rheumatic heart disease (RHD) prevention and vaccine development, infectious diseases physicians say.

Rheumatic heart disease screening: Current concepts and challenges

Rheumatic heart disease (RHD) remains one of the most preventable causes of heart disease in children and young adults worldwide and is the most common cardiovascular disease in those aged under 25 years.

Rheumatic heart disease: infectious disease origin, chronic care approach

Rheumatic heart disease (RHD) is a chronic cardiac condition with an infectious aetiology, causing high disease burden in low-income settings. Affected individuals are young and associated morbidity is high. However, RHD is relatively neglected due to the populations involved and its lower incidence relative to other heart diseases.

Scientists Link a Gene Mutation to Rheumatic Heart Disease

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The case for global investment in rheumatic heart-disease control

The relative burden and complexity of the disease have contributed to its neglect by governments, donors and decision-makers. We argue that the World Health Organization (WHO) and national governments should rekindle their rheumatic heart disease control programmes.

Resources

World Heart Federation

Rheumatic heart disease is a preventable yet serious public health problem in low- and middle-income countries and in marginalized communities in high-income countries, including indigenous populations. Every year, it claims more than 300,000 lives, accounting for nearly 2% of all deaths from cardiovascular disease—the number one cause of death globally. RHD most commonly occurs in childhood and can lead to death or life-long disability.

REACH

RhEACH is a technical support and policy translation initiative to amplify rheumatic heart disease control efforts locally, regionally and globally. We aim to identify, describe and disseminate solutions for this neglected disease and to reduce burden on vulnerable populations around the world.

RHD Action

RHD Action is the name given to the global movement to reduce the burden of rheumatic heart disease (RHD) in vulnerable populations of all ages throughout the world.

RHD Australia

To prevent and reduce acute rheumatic fever and rheumatic heart disease in Australia through education, awareness raising, quality data collection and reporting systems and national collaboration.

StatPearls

Rheumatic heart disease results from either a single or repeated attacks of rheumatic fever that results in rigidity and deformity of valve cusps, the fusion of the commissures, or shortening and fusion of the chordae tendineae. Over 2 to 3 decades, valvular stenosis and/or regurgitation results. In chronic rheumatic heart disease, the mitral valve alone is the most commonly affected valve in an estimated 50% to 60% of cases.

WHO

Where rheumatic fever and rheumatic heart disease are endemic, rheumatic heart disease is the principal heart disease seen in pregnant women, causing significant maternal and perinatal morbidity and mortality. Pregnant women with rheumatic heart disease are at risk of adverse outcomes, including heart arrythmias and heart failure due to increased blood volume putting more pressure on the heart valves. It is not uncommon for women to be unaware that they have rheumatic heart disease until pregnancy. Despite it being eradicated in many parts of the world, the disease remains prevalent in sub-Saharan Africa, the Middle East, Central and South Asia, the South Pacific, and among immigrants and older adults in high-income countries, especially in indigenous peoples.