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Rheumatic heart disease (RHD) causes ~250,000 premature deaths every year
Worldwide RHD is the leading cause of heart failure in children and young adults
RHD manifests as a combination of fever, polyarthritis, carditis, chorea, erythema marginatum, and subcutaneous nodules (major Jones Criteria)
Mitral valve incompetence is the most common valvular lesion and mitral stenosis usually develops later as a result of persistent or recurrent valvulitis with bicommissural fusion
Eradication of group A streptococcus with penicillin prevents the initial acute rheumatic attack
No treatment for RHD exists other than for its complications, including heart failure, atrial fib, ischemic embolic events, and infective endocarditis
References
Marijon E. Mirabel M. Celermajer DS. Jouven X. Rheumatic heart disease. Lancet. 379(9819):953-64, 2012 Mar 10.