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Lancet. 2012 Mar 10;379(9819):953-964. doi: 10.1016/S0140-6736(11)61171-9.

Rheumatic heart disease.

Author information

1
Paris Cardiovascular Research Centre, INSERM U970, European Georges Pompidou Hospital, Paris, France; Department of Cardiology, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Maputo Heart Institute (ICOR), Maputo, Mozambique. Electronic address: eloi_marijon@yahoo.fr.
2
Paris Cardiovascular Research Centre, INSERM U970, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; University College London, London, UK.
3
Sydney Medical School, University of Sydney, NSW, Australia.
4
Paris Cardiovascular Research Centre, INSERM U970, European Georges Pompidou Hospital, Paris, France; Department of Cardiology, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Maputo Heart Institute (ICOR), Maputo, Mozambique.

Abstract

Rheumatic heart disease, often neglected by media and policy makers, is a major burden in developing countries where it causes most of the cardiovascular morbidity and mortality in young people, leading to about 250,000 deaths per year worldwide. The disease results from an abnormal autoimmune response to a group A streptococcal infection in a genetically susceptible host. Acute rheumatic fever--the precursor to rheumatic heart disease--can affect different organs and lead to irreversible valve damage and heart failure. Although penicillin is effective in the prevention of the disease, treatment of advanced stages uses up a vast amount of resources, which makes disease management especially challenging in emerging nations. Guidelines have therefore emphasised antibiotic prophylaxis against recurrent episodes of acute rheumatic fever, which seems feasible and cost effective. Early detection and targeted treatment might be possible if populations at risk for rheumatic heart disease in endemic areas are screened. In this setting, active surveillance with echocardiography-based screening might become very important.

PMID:
22405798
DOI:
10.1016/S0140-6736(11)61171-9
[Indexed for MEDLINE]

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