Current Cardiology Reports

, 15:343

Echocardiographic Screening for Subclinical Rheumatic Heart Disease Remains a Research Tool Pending Studies of Impact on Prognosis

Valvular Heart Disease (V Nkomo, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Valvular Heart Disease

Abstract

The application of portable echocardiography to the screening of asymptomatic children and young adults for rheumatic heart disease (RHD) in developing countries indicates that the disease may affect 62 million to 78 million individuals worldwide, which could potentially result in 1.4 million deaths per year from RHD and its complications. The World Heart Federation has developed a guideline for the echocardiographic diagnosis of RHD in asymptomatic individuals without a history of acute rheumatic fever (ARF) in order to ensure the reliability, comparability, and reproducibility of findings of the echocardiographic screening studies. Early studies suggest that a third of individuals with asymptomatic subclinical RHD revert to normal echocardiographic findings on repeat testing after 6–12 months, suggesting that repeat echocardiography may be necessary to confirm the findings prior to consideration of interventions such as antibiotic prophylaxis. It is not known, however, whether echocardiographic screening for asymptomatic subclinical RHD or the introduction of antibiotic prophylaxis for affected individuals improves the prognosis of RHD. Furthermore, the cost-effectiveness of this screening method has not been established in the vast majority of affected countries. Therefore, echocardiographic screening for asymptomatic subclinical RHD remains a research tool until studies of impact on prognosis and cost-effectiveness are conducted.

Keywords

Rheumatic heart disease Echocardiographic screening Subclinical carditis World Heart Federation guidelines 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Division of Paediatric CardiologyRed Cross War Memorial Children’s Hospital and University of Cape TownCape TownSouth Africa
  2. 2.Department of MedicineOld Groote Schuur HospitalCape TownSouth Africa

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