Rheumatic fever (RF) and Rheumatic Heart Disease (RHD) remain significant causes of cardiovascular diseases in the world today.
 

Rheumatic heart disease is a preventable yet serious public health problem in low and middle-income countries and  in marginalized communities in high-income countries, including indigenous population. The disease results from damage to heart valves caused by one or several episodes of rheumatic fever, an autoimmune inflammatory reaction to throat infection caused by group A streptococci (streptococcal pharyngitis). It most commonly occurs in childhood and can lead to death or life-long disability

Socio-economic and environmental factors such as poor housing, under-nutrition, over-crowding and poverty increase the likelihood and the severity of the disease. There is currently no single test to diagnose acute rheumatic fever (ARF). Diagnosis is based on clinical assessment and the identification of a number of signs and symptoms that are associated with the illness. Signs and symptoms of ARF are divided into two categories: major and minor. 

Major signs and symptoms are strongly associated with ARF and include carditis (swelling of the heart), arthritis (pain, redness and swelling of one or more joints), Sydenham’s chorea (strange movements of the body and face), erythema marginatum (painless skin pigmentation), and subcutaneous nodules (small lumps under the skin).
Minor signs and symptoms are used to help support the diagnosis. These include fever, arthralgia (generalised joint aches), blood tests that suggest general illness (elevated ESR), and changes seen on electrocardiogram (Increased P-R interval).