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January 20, 2021

Screening for Rheumatic Heart Disease—Quo Vadis?

Author Affiliations
  • 1Global Health Unit, University of Paris, Paris, France
  • 2Department of Cardiology, Medicover Hospitals, Hyderabad, India
  • 3Department of Cardiology, European Georges Pompidou Hospital, Paris, France
JAMA Cardiol. 2021;6(4):375-376. doi:10.1001/jamacardio.2020.7063

Although mostly banished from Western training curricula, rheumatic heart disease (RHD), described as the malady that “licks the joints but bites the heart,”1(p1) continues to be responsible for major cardiovascular morbidity and mortality in the developing world.2,3 Rheumatic heart disease constitutes a double tragedy because it disproportionately affects economically disadvantaged people and young people, thereby robbing them of the most productive years of life. Often, by the time it is diagnosed, RHD has resulted in substantial valvular damage. Dealing with such established disease frequently necessitates cardiac surgery or catheter-based procedures, requiring tertiary care setups and significant financial resources, often beyond the reach of most people in the developing world. Therefore, the idea of diagnosing RHD at an early stage with the aim of preventing disease progression is a worthwhile goal. Despite multipronged research in the field, including efforts at a vaccine,4 the only preventive strategy proven to make a difference thus far is antibiotic prophylaxis to prevent acute rheumatic fever recurrences.

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