Health Problems
Acute rheumatic fever, which is followed by rheumatic heart disease is a major concern for health providers in developed countries. This article has identified, using proper health and medicare statistics, that the prevalence of rheumatic heart disease observed in a high risk population in New Zealand that was socio-economically deprived. The major aim of the study was to compare the sensitivity and specificity of cardiac auscultation to echocardiography. Since rheumatic heart disease prevalence increases with age, the study was conducted in children of 10-13 years.
This article is different from the non peer reviewed article. It has used clear sequential clinical measures for diagnosis of rheumatic diseases, that may lead to rheumatic heart disease if not identified and treated at early age. In the non peer reviewed article, however, the authors are suggesting that the people who smoke heavily, who have high cholesterol, high blood pressure, diabetes, or a family history of heart disease, are probable patients of silent ischemia, which can cause angina without presenting pain. Second, the peer reviewed article clearly indicates using scientific methods of analysis that the study can be used for better diagnosis and prophylaxis measures, and it has a strong basis of correlating the current study with any good clinical studies done elsewhere.
The study is designed in logical steps. The first diagnosis is done using portable echocardiography, followed by hospital based screening. Rheumatic heart disease was then classified as definite, probable, or possible. This study confirmed that echocardiography is more sensitive and specific than cardiac auscultation, and excludes false-positive pathological cardiac murmurs. A follow-up clinical assessment by a paediatric cardiologist together with a hospital-based echocardiography ensured that false negatives are also avoided. Congenital mitral valve variations are also significant, but they can be distinguished from rheumatic heart disease using these screening procedures. This study also paves the way for more stringent Doppler criteria to achieve international standardization in the screening and diagnosis of rheumatic heart diseases. This study also underlines the inadequacy of the currently used clinical screening procedures, which fail in diagnosing rheumatic diseases. In addition, the study was able to identify congenital cardiac defects in a similar way to larger studies. Though the study has a limitation in defining the prognosis in the majority of possible rheumatic heart disease cases, it is possible to prevent the prognosis of the rheumatic heart disease in the definite and possible conditions, using prophylaxis measures.

The prevalence of heart diseases, as exemplified by rheumatic heart disease or silent ischemia/angina in the previously analyzed articles, clearly indicates that despite advances in modern medicine, there is a clear need for better healthcare in heart diseases. This need is not limited to developing countries, but is equally evident in developed countries as well. A proper standardization of diagnosis measures and prophylaxis and treatment plan based on is required to meet these needs. These measures may change as per the resources available.
Heart diseases can affect virtually every organ of the body, starting from brain to bones, and liver to kidneys. Though heart disease is a general definition, it may involve diseases of your blood vessels, such as coronary artery disease; heart rhythm problems (arrhythmias); heart infections; and heart defects you’re born with (congenital heart defects). Many of the heart diseases can be clearly identified and prevented. The specific treatments vary with the type of heart diseases. But they can be classified based on their mechanism of action. The treatment for elevated blood pressure indicates diuretics and beta blockers, while the treatment for angina will utilize vasodilators as well. There are altogether different treatments for rheumatic heart diseases.
Preventing heart diseases is equally important as that of preventing social crimes, since both affect the well being of citizens to the same levels. A prevalent heart disease can lead to stroke or paralysis which is a major burden to healthcare. Hence, it is important to use proper healthcare measures in identification of health problems. The job of a healthcare provider is very tough and challenging in this case. It is however, very rewarding since it can improve the well being of the society as a whole. A proper prophylaxis not only reduces the burden on healthcare in terms of reimbursements, but also helps to reduce the load on critical care administrators in the hospital setting. As a whole, it is important for health care provider to educate people for the proper diagnostic and prophylactic measures.
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