Write a clinical update on Rheumatic Heart Disease.

Introduction

Rheumatic heart disease (RHD) is manifested through the invasion by beta-haemolytic streptococcal pharyngitis (Kumar & Tandon, 2013). The establishment of this disease occurs after the occurrence of rheumatic fever under the influence of GABHS (Group A β hemolytic Streptococcus) or Streptococcus pyogenes infestation (Seckeler & Hoke, 2011). The pattern of molecular mimicry between the human proteins and the structure of Streptococcus pyogenes antigen leads to the occurrence of cell-mediated and humoral autoimmune reactions that primarily causes the onset and establishment of rheumatic heart disease and rheumatic fever in the infected patients (Chopra & Gulwani , 2007). Indeed, rheumatic heart disease is the cardiovascular outcome of acute rheumatic fever, and its endemic occurrence perpetuates in the absence of primary prevention strategies and disrupted economic and social development processes in the underdeveloped and developing nations of the world. The pattern of RHD influences the cardiovascular health of more than 33 million individuals across the globe. RHD leads to the occurrence of 1%-1.5% of the entire cardiovascular mortalities and 3%-4% co-morbidities (attributing to adjusted life years due to cardiovascular disability). Rheumatic heart disease manifestations prove to be the leading cause of recurrent hospital admissions, as well as invasive cardiac interventions warranted for treating the pattern of initial cardiac trauma among the affected patients (Santos, et al., 2017). Research analysis by (Watkins, et al., 2017) reveals a 47.8% age-appropriate global mortality rate (under the influence of RHD) recorded between 1990-2015. Rheumatic heart disease predominantly influences the indigenous population in the Australian regions. Evidence-based analysis by (Ferretti, Stevens, & Fischetti, 2016) reveals the elevated incidence of acute rheumatic fever (i.e. 155/100,000) across the paediatric population in North Queensland. On a global scale, RHD leads to 250,000 mortalities in youngsters (Liu, Lu, Sun, Zheng, & Zhang, 2015). RHD adversely influences the socially disadvantaged and underprivileged population in the Australian regions (Colquhoun, et al., 2015).

The absence of hygiene, healthcare inaccessibility, deteriorated psychosocial condition, financial constraints, and lack of disease awareness are some of the significant psycho-socio-economic determinants of RHD in Australian aboriginal individuals (Colquhoun, et al., 2015). RHD related morbidities occur on a larger scale among the indigenous youngsters in comparison to the elderly individuals. The evidence-based research literature reveals 59% mortalities in the non-indigenous Australian population under the influence of RHD manifestations (Colquhoun, et al., 2015). This clinical update concisely provides an evidence-based insight of the causative factors, pathogenesis, symptomatology, diagnostic Process and treatment interventions of rheumatic heart disease for the registered nurse practitioners.

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