Updated clinical guideline improves detection of rheumatic heart disease

Giovanni Torre
Giovanni Torre Published June 16, 2025 at 4.30pm (AWST)

Menzies School of Health Research and the Heart Foundation of Australia have released an updated clinical practice guideline that includes fundamental changes to support improved diagnosis of rheumatic heart disease and prevent disease progression, based on international standards.

This brings Australia in line with the World Heart Federation's criteria for RHD diagnosis and supports clinicians who care for people living with, or at risk of, acute rheumatic fever (ARF) and RHD - conditions that significantly impact Indigenous communities.

ARF and RHD are preventable, yet in Australia they still impact more than 11,000 people due to health inequity. Almost 80 per cent of people diagnosed with RHD are First Nations peoples, with more than a third aged under the age of 25 years. These impacts highlight the key importance of addressing this condition to Close the Gap and to meet the national commitment to eliminate RHD in Australia by 2031.

"Collaborating on this guideline aligns with our vision to support health professionals in their work to prevent, diagnose, treat, and manage heart disease," said Heart Foundation CEO, David Lloyd.

"Our generational vision for heart health in Australia focuses substantially on advancing heart health equity and a key component of this is supporting collective efforts to end acute rheumatic fever and rheumatic heart disease. The updated guideline contributes to the elimination efforts of these preventable illnesses."

Menzies Deputy Director (Research) and Senior Editor of the Guideline, Professor Anna Ralph, highlighted the impact the new RHD diagnostic criteria will have on health research and clinical care.

"Accurate interpretation of echocardiograms to ensure RHD is not missed and severity is graded in a consistent way, ensures that the right treatment is provided from the outset," said Professor Ralph.

"For ARF and RHD care to be effective in Australia, clinical recommendations need to be practical, and the needs of First Nations people have to be incorporated into all aspects of care.

"A cultural safety framework underpins the guideline, which recognises the persistent high rates of disease among First Nations peoples and places the needs of the patient and their family at the centre of care."

Since its last major revision in 2020, the guideline has been downloaded more than 164,000 times, demonstrating its value as a key resource in supporting ARF and RHD care across Australia, and internationally.

The ARF and RHD Guideline is driven by a range of clinical experts and relevant stakeholders. To support implementation of this guideline update, this group will work with clinicians, RHD control programs and other stakeholders to support the uptake and integration of the changes.

The 2025 guideline edition has been made possible through funding from the Heart Foundation of Australia.

The Australian guideline for the prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease (edition 3.3) is available via the RHD Guideline website.

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