Introduction The clinical course of both acute rheumatic fever (ARF) and rheumatic heart disease (RHD) may be complicated by acute life-threatening conditions. This chapter will focus on: (1) the clinical evaluation, diagnosis, and management of acute heart failure (AHF); (2)…
Introduction Health-seeking behavior is a critical determinant of success for rheumatic heart disease (RHD) control programs. If people at risk of RHD do not seek care for group A streptococcal (GAS) infections, primary prevention is impossible. If they do not…
Introduction Although a reinvigorated global vaccine development effort gives legitimate reason for cautious optimism, it is a sad reality that in 2019 the best introduction to a discussion on vaccines for group A Streptococcus (GAS) comes from 1967, by Professor…
Introduction Over the past decade, echocardiographic screening for rheumatic heart disease (RHD) has emerged as a potentially transformative strategy for global RHD control. School-aged children from nearly every continent have been screened under the premise of epidemiology or research. New…
Rheumatic Heart Disease Control Programs Disease control is the “reduction in the incidence, prevalence, morbidity, or mortality of an infectious disease to a locally acceptable level.” Efforts to control acute rheumatic fever (ARF) and rheumatic heart disease (RHD) have been…
Introduction Definition of Secondary Prevention Individuals within a vulnerable age group who have had an episode of acute rheumatic fever (ARF), or already have established rheumatic heart disease (RHD), are at high risk of recurrence of ARF if further episodes…
Primordial Prevention Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are predominantly diseases of social, environmental, and economic poverty. Primordial prevention, defined as improving socioeconomic and living conditions, and having well-organized, effective health systems, is arguably the most important…
Introduction Heart disease is the highest indirect (nonobstetric) cause of mortality for pregnant women in both high-income countries (HICs) and low- and middle-income countries (LMICs). Valvular heart disease is an important contributor to the burden of maternal disease, accounting for…
Introduction New cases of acute rheumatic fever (ARF) have almost disappeared from most high-income countries (HICs), where rheumatic heart disease (RHD) is now a remnant of the past and usually only seen in the older population where it does not…
Introduction Rheumatic heart disease (RHD) remains the most common cause of multivalvular heart disease worldwide, and a major cause of cardiac morbidity and mortality in low- and middle-income countries. The definitive management of patients with advanced rheumatic valvular disease includes…