Lest we Forget: Rheumatic Fever is Still Damaging Hearts

Rheumatic Heart Disease (RHD) is still a burden in many developing countries and indigenous communities within developed countries. A simple sore throat caused by the Group A β-hemolytic Streptococcus bacterium in children, teenagers and young adults, unrecognized and/or under-treated, is all it takes to begin a whole cascade of damage to the heart valves and other cardiac structures resulting in valvular stenosis and incompetence. Its complications are enormous ranging from life-long morbidity and reduced productivity, need for open heart surgery for valvular repair or replacement (often requiring long term anticoagulation), risk of strokes, increased financial burden to individuals and health systems, and many more. Many heart valve replacement surgeries even in developed countries are, still, a result of rheumatic valvular heart disease. Yet many clinicians remain very much confused as to how to recognize and prevent this condition.