RHD patients seek treatment in the very late stages of disease

Leading Middle East cardiologists call for adoption of rheumatic heart disease screening and prevention programs at the World Congress of Cardiology

Patients with rheumatic heart disease (RHD) are being admitted to hospital too late to prevent the need for heart surgery, according to a new study carried out by doctors in Yemen and presented today at the World Congress of Cardiology.

RHD is a devastating consequence of repeated episodes of rheumatic fever. The disease progresses over time and if it is not caught in the early stages, patients develop heart valve damage and will ultimately need surgery to replace the damaged valve(s).

A recent study in Yemen showed that 43 per cents mitral value - and more than half were considered to have severe stenosis. Of those 87 patients followed, 53 per cent were recommended for percutaneous balloon mitral valvuloplasty (BMVP) - where the abnormally thickened mitral valve is dilated; a further 29 per cent were recommended for valve replacement surgery; while only 18 per cent were entered into a follow-up programme without interventional therapy of any kind.

"These results clearly demonstrate that RHD patients are seeking treatment from their doctors in the very late stages of their disease," said Dr. A. Sharafaddeen, Algomori Hospital, Taiz, Yemen. "But the management of these patients is costly. This money could be rather used much more efficiently in preventing and screening for the disease in its early stages."

Indeed, coordinated screening and control programmes to prevent progression to severe RHD can be carried out relatively cheaply.

"RHD can be prevented easily using penicillin - a cheap and readily available treatment," said Dr. Fahad Baslaib, President, Emirates Cardiac Society. "The funding required is minimal and control could be achieved by re-prioritizing existing budgets. We therefore have to consider implementing screening programmes in this region as a matter of urgency."