Mobile phone-based rheumatic heart disease diagnosis

The review refl ects modern data on the epidemiology of acute rheumatic fever and chronic rheumatic heart disease in Russia and the world at present, as well as the dynamics of the prevalence of these diseases over the past decades. Much attention is paid to the issues of modern diagnostics of these conditions by physical, laboratory and instrumental methods. The focus is on the Jones criteria in the diagnosis of acute rheumatic fever in accordance with their revision by the American Heart Association experts in 2015. Taking into account the fact that damage to the valvular apparatus of the heart in acute rheumatic fever is the main disabling outcome of carditis at the present stage, a special place in the article is devoted to the discussion of echocardiographic criteria for valvulitis. The recommendations of the International Expert Council of the World Heart Federation aimed at detecting chronic rheumatic heart disease in patients without a history of acute rheumatic fever diagnosed by ultrasound imaging are also given. Criteria for pathological aortic and mitral regurgitation are presented. The authors believe that extrapolation of modern principles of ultrasound diagnostics of chronic rheumatic heart disease in Russia and their use as screening programs in young people and adolescents will contribute to its early detection and timely selection of patients for secondary prevention of benzathine with benzylpenicillin.

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Long-term outcomes following Rheumatic Heart Disease diagnosis in Australia

European Heart Journal Open ◽

10.1093/ehjopen/oeab035 ◽

2021 ◽

Author(s):

Ingrid Stacey ◽

Joseph Hung ◽

Jeff Cannon ◽

Rebecca J Seth ◽

Bo Remenyi ◽

...

Keyword(s):

Heart Disease ◽

Rheumatic Heart Disease ◽

Disease Diagnosis ◽

Cardiovascular Complications ◽

Cardiovascular Complication ◽

Study Cohort ◽

Composite Outcome ◽

Hospital Data ◽

Cardiac Morbidity ◽

Rheumatic Heart

Abstract Aims Rheumatic Heart Disease (RHD) is a major contributor to cardiac morbidity and mortality globally. We aimed to estimate the probability and predictors of progressing to non-fatal cardiovascular complications and death in young Australians after first RHD diagnosis. Methods and Results This retrospective cohort study used linked RHD register, hospital and death data from five Australian states and territories (covering 70% of the whole population and 86% of the Indigenous population). Progression from uncomplicated RHD to all-cause death and non-fatal cardiovascular complications (surgical intervention, heart failure, atrial fibrillation, infective endocarditis, stroke) was estimated for people aged <35years with first-ever RHD diagnosis between 2010 and 2018, identified from register and hospital data. The study cohort comprised 1718 initially uncomplicated RHD cases (84.6% Indigenous; 10.9% migrant; 63.2% women; 40.3% aged 5-14-years; 76.4% non-metropolitan). The composite outcome of death/cardiovascular complication was experienced by 23.3% (95% CI: 19.5-26.9) within 8 years. Older age and metropolitan residence were independent positive predictors of the composite outcome; history of acute rheumatic fever (ARF) was a negative predictor. Population group (Indigenous/migrant/other Australian) and sex were not predictive of outcome after multivariable-adjustment. Conclusion This study provides the most definitive and contemporary estimates of progression to major cardiovascular complication or death in young Australians with RHD. Despite access to the publically-funded universal Australian healthcare system, one-fifth of initially uncomplicated RHD cases will experience one of the major complications of RHD within 8 years supporting the need for programs to eradicate RHD.

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