Rheumatic fever/rheumatic heart disease, contemporary concepts, emerging paradigms and Indian perspective

Abstract:

Rheumatic fever and rheumatic heart disease remain preventable yet persistent cardiovascular disorders in India and other endemic regions. Their continued burden reflects not only streptococcal infection, but also poverty, crowding, delayed diagnosis, weak surveillance, and inconsistent secondary prophylaxis. Contemporary evidence has broadened the classical throat-centred model to include skin infection as a possible trigger in tropical settings. Echocardiography has revealed a large hidden burden of subclinical disease, while handheld devices may improve access to early detection. However, the application of these technologies in screening is not yet widespread. Benzathine penicillin G remains central to prevention, but adherence and supply remain major barriers. Sustainable control will require integrated public-health, diagnostic, and prophylaxis strategies. Vaccines and artificial intelligence may define the road beyond the last mile.