Medical Management of Rheumatic Heart Disease

Emmy Okello, Ify Mordi, Chim Lang, Craig Sable, Scott Dougherty, Nigel Wilson

Research output: Chapter in Book/Report/Conference proceedingChapter (peer-reviewed)peer-review

1 Citation (Scopus)


Best practices guidelines for the long-term management of rheumatic heart disease (RHD) include secondary prevention with penicillin prophylaxis, clinical reviews by a specialist experienced in RHD management, serial echocardiographic assessment of left ventricular and valve function, timely referral for heart surgery, monitoring of anticoagulation for patients with atrial fibrillation and mechanical heart valves, and access to oral healthcare.

There is an established evidence base for surgical or catheter-based intervention for severe or symptomatic RHD patients, whereas there is little evidence that pharmacological management of severe RHD changes outcomes. Unfortunately, the vast majority of the global burden of symptomatic RHD exists in regions of the world where there is limited or no access to surgical or catheter-based treatment. As a result, medical management is often the only option and may allow for symptomatic improvement.

This chapter discusses the principles of medical management of RHD and the indications for surgical or catheter-based treatment.

Original languageEnglish
Title of host publicationAcute Rheumatic Fever and Rheumatic Heart Disease
EditorsScott Dougherty, Jonathan Carapetis, Liesl Zuhlke, Nigel Wilson
Number of pages26
ISBN (Electronic)9780323754606
ISBN (Print)9780323639828
Publication statusPublished - 25 Feb 2020


  • Acute rheumatic fever
  • Atrial fibrillation
  • Heart failure
  • Medical management
  • Rheumatic heart disease
  • Valvular heart disease

ASJC Scopus subject areas

  • Medicine(all)


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