One of Haiti's Scourges--Rheumatic Heart Disease--2009

One of Haiti's scourges is Rheumatic Heart Disease. 

In the mid 20th century, children with rheumatic fever occupied many of the beds in pediatric wards in industrialized countries--indeed, entire hospitals were dedicated to the treatment of, and rehabilitation from rheumatic fever. But in the latter half of the 2Oth century, rheumatic fever receded as an important health problem in almost all wealthy countries.

Most of the reduction in cases of rheumatic fever around the world is attributable to improved living conditions, which have resulted in less overcrowding and better hygiene, with a reduction of transmission of group A streptococci.

Today, most physicians in resource-rich countries are unlikely to see a case of acute rheumatic fever. And their experience with rheumatic heart disease will be limited to heart-valve lesions in older patients who had rheumatic fever in their youth.

Roldophe is a Haitian Hearts patient who we brought for heart surgery in the 2010s. He had Rheumatic Heart Disease that damaged his mitral valve. See this video of Roldophe after his heart surgery when I was examining him in Port-au-Prince. He had Sydenham's Chorea which is seen with rheumatic fever. This type of chorea usually resolves on its own as it did with Roldophe. 

Roldophe was the third case I have seen. Has anyone ever seen post-operative Sydenham's Chorea?