Rheumatic heart diseases

Abstract

Acute rheumatic fever (ARF) is an autoimmune disease usually seen in the 5-15 age group of underdeveloped or developing countries and occurs against pharyngitis caused by Group A Streptococcal (GAS) infection. The disease's major clinical findings are carditis, arthritis, erythema marginatum, Sydenham's chorea, and subcutaneous nodules. A single or recurrent episode of ARF causing long-term damage to the heart valves is called rheumatic heart disease (RHD). It is the most severe complication of ARF. RHD is a significant cause of mortality and morbidity worldwide. The Jones criteria, developed in 1944 and revised several times, are used to diagnose ARF. In the Jones criteria, last revised in 2015, different diagnostic criteria were established for moderate/high-risk and low-risk populations. Penicillin therapy has been the mainstay therapy for decades, both in treatment and prevention. In RHD management, it is essential to protect the patient from possible recurrence with penicillin prophylaxis and to follow up the left ventricular function and valve functions at regular intervals with echocardiography by an experienced specialist. The main solutions in preventing the disease are improving socioeconomic conditions and health services and vaccination studies against group A streptococcal infections.