Abstract
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 language | English |
|---|---|
| Title of host publication | Acute Rheumatic Fever and Rheumatic Heart Disease |
| Editors | Scott Dougherty, Jonathan Carapetis, Liesl Zuhlke, Nigel Wilson |
| Publisher | Elsevier |
| Chapter | 6 |
| Pages | 107-132 |
| Number of pages | 26 |
| Edition | 1 |
| ISBN (Electronic) | 9780323754606 |
| ISBN (Print) | 9780323639828 |
| DOIs | |
| Publication status | Published - 25 Feb 2020 |
Keywords
- Acute rheumatic fever
- Atrial fibrillation
- Heart failure
- Medical management
- Rheumatic heart disease
- Valvular heart disease
ASJC Scopus subject areas
- General Medicine