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Rheumatic heart disease

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Fact sheet - Health conditions directory

Rheumatic heart disease (RHD) is a notifiable chronic condition caused by damage to the heart valves, which occurs after single or repeated episodes of acute rheumatic fever (ARF). ARF is an autoimmune disease which occurs following infection with Group A Streptococcus bacterium (Strep). Repeated episodes of ARF can lead to accumulative damage to the heart valves, which may require surgery.

If untreated, RHD can lead to heart failure and complications like stroke and can greatly reduce the ability to lead a normal life.

RHD can cause complications in pregnancy.

Risk groups for RHD

At high risk

  • Living in an ARF-endemic setting (e.g. ARF incidence >30/100,000 per year in 5 to 14-year-olds, or RHD prevalence >2/1000).
  • Aboriginal and/or Torres Strait Islander peoples living in rural or remote settings;
  • Aboriginal and/or Torres Strait Islander peoples, and Maori and/or Pacific Islander peoples living in metropolitan households affected by crowding and/or lower socioeconomic status.
  • Personal history of ARF/RHD and aged <40 years.
  • Family or household recent history of ARF/RHD.

May be at high risk/additional considerations
  • Family or household recent history of ARF/RHD.
  • Household overcrowding (2 or more people per bedroom) or low socioeconomic status.
  • Migrant or refugee from low-or-middle-income country and their children.
  • Prior residence in or frequent recent travel to a high ARF risk setting.
  • Aged 5 to 20 years (peak years for ARF).

Strep infections, ARF and RHD are preventable with improved housing and living conditions and early antibiotic treatment.

Public health management guidelines


Attending medical practitioners/medical superintendents (or delegates)

Notification resources

Resources for health professionals

RHD Australia - information and resources for families, community and health care workers; including professional development and rheumatic heart disease programs.

Rheumatic Heart Disease Action Plan 2018 - 2021 (PDF, 1.4MB)

Last updated: 5 June 2023

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