Echocardiographic screening for rheumatic heart disease: issues for the cardiology community.

The advent of portable echocardiography has led to screening for rheumatic heart disease (RHD) with high disease prevalence found in many countries. Data are presented from studies from India, Africa, and New Zealand. The natural history of subclinical echocardiographically detected RHD is the most important research question to be answered before more widespread screening is endorsed. The 2012 World Heart Federation (WHF) criteria for the echocardiographic diagnosis of RHD provide standardization of RHD diagnosis, increasing the specificity for definite RHD and raising the threshold for borderline RHD. Use of the criteria should reduce the false positive rate for minor echocardiographic changes due to physiological valvular regurgitation. This review highlights issues of screening for RHD that are of relevance to the cardiology community.