Structural Heart Diseases

Structural heart diseases constitute a large proportion of the burden of cardiovascular disease in low- and middle-income countries (LMICs). Some conditions, such as rheumatic heart disease (RHD) and Chagas disease (CD), are associated with poverty and are preventable. Congenital heart disease (CHD), in contrast, is prevalent in all regions, but treatment is more readily available in higher-income countries. All structural heart diseases have a progressive course in the absence of prevention or surgical treatment.

This chapter summarizes the key clinical and public health issues around three key groups of structural heart disease: major congenital heart defects, RHD, and CD. Although advanced surgical care for these conditions is a rapidly evolving topic, this chapter emphasizes the importance of primary prevention and early detection, which are the missing links in many programs. These activities have particular relevance in resource-constrained settings, where access to advanced surgical and interventional care is not feasible.