Treatment of Advanced Rheumatic Heart Disease Without Access to Cardiac Surgical Intervention

Advanced rheumatic heart disease (RHD) carries a severe prognosis. When cardiac surgical intervention — the definitive treatment — is not available, clinical priorities shift to managing symptoms and preserving quality of care. This protocol addresses that specific and underserved situation.

Clinical Scenario Most children and young adults with RHD worldwide do not have access to life-saving cardiac surgical intervention. In these resource-limited settings, the clinical challenge is to provide meaningful relief within the constraints of available therapies.

Approach (partial) Management centres on pharmacological agents that target respiratory distress and support comfort at the end of life. The structured protocol specifies which agents to use and how to apply them — details available in the full regimen below.

Instant Access to Structured Evidence-Based Regimens

References

Unfortunately, most children and young adults in the world with RHD do not have access to life-saving cardiac surgical intervention.

Diuretic drugs and morphine are proven to reduce respiratory distress and improve the quality of end-of-life care, yet these are not currently available to the majority of the world's population.

DOI: 10.1161/CIR.0000000000000921 View source ↗