Abstract
This focused review presents a critical appraisal of the World Heart Federation criteria for the echocardiographic diagnosis of rheumatic heart disease (RHD) and its performance in African RHD screening programmes. It identifies various logistical and methodological problems that negatively influence the current guideline’s performance. The authors explore novel RHD screening methodology that could address some of these shortcomings and if proven to be of merit, would require a paradigm shift in the approach to the echocardiographic diagnosis of subclinical RHD.
Highlights
Rheumatic heart disease (RHD) remains one of the leading causes of cardiovascular morbidity and mortality in developing countries (1)
The communique is a seminal position statement devised by RHD clinicians and researchers affiliated with the Pan-African Society of Cardiology (PASCAR) and outlies seven priority areas of action for the eradication of RHD in Africa
The identification of these morphological features could represent the most specific predictor for true RHD (25, 62, 63). If this hypothesis is demonstrated to be true, could the finding of subclinical RHD disease regression be a false representation of the natural history of true RHD and could the current World Heart Federation (WHF) screening methodology be responsible for perpetuating this anomaly?
Summary
L D Hunter[1], M Monaghan[2], G Lloyd[3], A J K Pecoraro[1], A F Doubell[1] and P G Herbst[1]
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