management and diagnosis of chronic rheumatic heart disease

Implementing guidelines on the diagnosis and management of chronic RHD has clinical importsnce to reducace recurrent of RHD among patients. in addition to accsess to appropriate primary care services, best, practice for RHD requires:
-access to a specialist physician and/or cardiologist(preferably the same specialist over a long time)
-acces to echocardiograpy- portable echocardiography may be required so that all RHD patients have access to echocardiography, regardless of location;
-adequate monitoring of anticoagulation therapy in patiens with atrial fibrillation and/ or mechanical prostheric valves: and
-secondary prevention with penicillin prophylaxis.

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