Forget Acute Rheumatic Fever Strategy

Almost a century ago acute rheumatic fever and rheumatic heart disease were recognized as clinically distinct entities. For a physician iceberg tip is what matters and symptomatic rheumatic heart disease on an average presents with morbidity and mortality much later compared to acute rheumatic fever. This manifest sequence overshadowed the hidden undercurrent. Echo-Doppler methods have revealed that acute rheumatic fever may at best be a complication of rheumatic heart disease and at the worst, it may be an unrelated disease.