Rheumatic heart disease (RHD) is the late sequelae of inadequately treated group A streptococcal pharyngeal infections, leading to acute rheumatic fever, a multisystem immune response that often culminates in valvular damage and ultimately heart failure (HF).1 While advanced rheumatic valvular disease is ideally treated with interventional procedures (surgical or percutaneous), the reality is that access to these procedures is severely constrained in many RHD-endemic areas, limiting patients to medical management for symptom control.2

There are very limited data on the best practices for medical management of RHD, with most recommendations drawn from what is known from the general literature on HF, supraventricular arrhythmias and valvular heart disease. This is problematic because the population of patients with RHD is both younger and less likely to have secondary cardiac risk (such as coronary artery disease and hypertension) as compared with the general HF and valvular heart disease communities. In…

Source link