Acute rheumatic fever and rheumatic heart disease

TLDR: Progress in developing group A streptococcal vaccines and an increased focus on the lived experience of those with RHD and the need to improve quality of life give cause for optimism that progress will be made against this neglected disease.

Abstract: Despite economic and medical advances, acute rheumatic fever and consequent rheumatic heart disease remain a major public health burden in low and middle-income countries, and a designated priority for the World Health Organisation. The clinical consequences are major and enduring, particularly for women of child-bearing age, and access to diagnosis, preventive therapy and transcatheter or surgical interventions remains a challenge. Herein, we provide a summary of key aspects of the condition, with particular focus on epidemiology, pathogenesis and immune mechanisms, diagnosis and clinical manifestations, contemporary management and preventive strategies.