Acute Rheumatic Fever And Rheumatic Heart Disease

Acute Rheumatic Fever and Rheumatic Heart Disease is a concise, yet comprehensive, clinical resource highlighting must-know information on rheumatic heart disease and acute rheumatic fever from a global perspective. Covering the major issues dominating the field, this practical resource presents sufficient detail for a deep and thorough understanding of the latest treatment options, potential complications, and disease management strategies to improve patient outcomes. Divided into four distinct sections for ease of navigation: Acute Rheumatic Fever, Rheumatic Heart Disease, Population-Based Strategies for Disease Control, and Acute and Emergency Presentations. International editors and chapter authors ensure a truly global perspective. Covers all clinical aspects, including epidemiology, pathophysiology, clinical features, diagnosis, management, and treatment. Includes key topics on population-based measures for disease control for effective primary, secondary, and tertiary prevention. Consolidates today’s available information and guidance into a single, convenient resource.

Today rheumatic fever is still the most common cause of heart disease in children and young adults in developing countries. This disease is typically associated with poverty, in particular with poor housing, overcrowding and inadequate medical care. Rheumatic fever has almost disappeared from economically developed countries; this trend has paralleled improvements in standards of living. However, the recent resurgence of rheumatic fever in middle-class families in the U. S. A. has re-emphasized the importance of this disease in the developed countries as well. Prevention and control of rheumatic fever and rheumatic heart disease is an important part of the WHO cardiovascular disease program. Based on earlier WHO experience, and on the magnitude of the problem, it was realized that concerted action was needed to combat this significant cause of cardiovascular morbidity and mortality. The present program has been developed on the principle that sound knowledge and reliable technology already exist for implementing community programs for the prevention and control of rheumatic fever and rheumatic heart disease with the intention of extending activities toward nationwide coverage. The first edition of this book was an excellent instrument to assist in the control of this disease. The present volume with dissemination of knowledge to health personnel will contribute to closing the gap between knowledge and implementation and it links with WHO's endeavors in prevention and control of rheumatic fever and rheumatic heart disease.

This book provides a comprehensive guide to Acute Rheumatic Fever (ARF) and Chronic Rheumatic Heart Disease RHD). Beginning with a review of the history of these conditions, the text continues with a discussion on the pathology and diagnosis of both ARF and RHD, the role of echocardiography, management of the conditions, including during pregnancy; treatment and much more. The book is accompanied by a DVD of echocardiographic videos to assist in the detection and diagnosis of the diseases.

Rheumatic heart disease presents a major public health challenge (particularly for children) and major determinants are poverty, malnutrition, overcrowding, poor housing and a shortage of health-care resources. Although cost effective prevention and control strategies are available, they remain underused in most developing countries. This publication contains the report of a WHO expert consultation, held in Geneva in October 2001, which reviewed the current scientific knowledge of rheumatic fever and rheumatic heart disease, as well as the medical and public health related practices. It suggests practical recommendations for an evidence-based approach to the prevention and management of the disease and for cost-effective programmes for their control.

It has become commonplace to say that the decline of rheu matic fever in Europe and North America has little, if any thing, to do with medicine; but to conclude that efforts to control the disease are futile would be an error leading to what could be termed public health malpractice. The need for adequate treatment of patients suffering from acute rheu matic fever or chronic rheumatic valvular heart disease is obvious; but control also means prevention, and here, too, the need is obvious, if only to lighten the burden on health care, due especially to the treatment of patients with advanced forms of the disease. The feasibility of and justification for rheumatic fever control programmes in developing countries has been often questioned. A co-operative study co-ordinated by the World Health Organization has now demonstrated that systematic prevention of rheumatic fever recurrences not only benefits the patients concerned but also has economic advantages. Primary prevention by systematic penicillin treatment of all streptococcal throat infections is at present beyond the reach of many health care systems, and anti-streptococcal vac cination is still in the research phase. The mainstay of the combat against rheumatic heart disease thus remains 7 RHEUMATIC FEVER secondary prevention - the long-term monthly administ ration of penicillin injections to identified patients. This requires, among other things, that penicillin be available.