GP · aboriginal-and-torres-strait-islander-health
Acute rheumatic fever and rheumatic heart disease
Also known as ARF · RHD · Rheumatic fever · Rheumatic heart disease
GP-fellowship guide to acute rheumatic fever and rheumatic heart disease: the autoimmune sequela of group A streptococcal infection, 2015 Jones criteria diagnosis, secondary prophylaxis with monthly benzathine penicillin G as the cornerstone of control, register-based follow-up care, pregnancy risks, echo screening in high-risk populations, and the housing and social determinants that drive the world's highest burden in Aboriginal and Torres Strait Islander communities.
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Red flags
- Sore joints, chorea, or new cardiac murmur in a high-risk child requires full ARF investigation
- ARF recurrence risk is highest in the first five years after the initial episode - secondary prophylaxis adherence is critical
- Pregnancy with RHD carries three- to six-fold increased risk of major adverse cardiac events
Overview
Acute rheumatic fever (ARF) is an autoimmune disorder resulting from group A streptococcal (GAS) pharyngitis or impetigo in children and adolescents, which may evolve to rheumatic heart disease (RHD) with persistent cardiac valve damage. RHD causes substantial mortality and morbidity globally, predominantly among socioeconomically disadvantaged populations.[2] ARF and RHD remain major drivers of preventable cardiovascular mortality and disability in low-income and middle-income countries.[1]
References21ShowHide
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