The patient has severe rheumatic mitral valve insufficiency. This could have been prevented with penicillin to treat his initial strep throat infection. Through a translator, Jean Baptiste tells you that he could not see a doctor when he had a sore throat.
The underlying cause was untreated strep pharyngitis. This could largely have been prevented by oral antibiotics (penicillin). This patient did not have access to antibiotics because of the lack of medical care in rural Haiti.
Globally, rheumatic heart disease is the leading cause of pediatric heart failure and cardiovascular death, and 80–85% of children worldwide live in areas where it is endemic.
However, the disease has essentially been eliminated in developed countries. It is now a disease of poverty. “Acute rheumatic fever and rheumatic heart disease can be regarded as physical manifestations of poverty and social inequality.”
- Marijon E, et al. Rheumatic Heart Disease. The Lancet, 2012;379(9819):953–964.
- Rothenbuhler M., et al. Active Surveillance for rheumatic heart disease in endemic regions. Lancet Glob Health, 2014;2(12):e717–26.
- WHO: Western Pacific.
- What is Health Policy and Systems Research (HPSR)?
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