Relationship between Patient Understanding of Disease and Rheumatic Heart Disease Progression in American Samoa

Introduction: While mostly eradicated in developed nations, acute rheumatic fever (ARF) and its sequela, rheumatic heart disease (RHD), are still the leading causes of preventable cardiovascular disease in children and young adults. In particular, the population of American Samoa has a high prevalence of RHD at 12.9%. ARF is a delayed consequence of a pharyngeal infection with Group A β-hemolytic streptococci, causing high-pressure valvular regurgitation and later stenosis which can lead to cardiac failure and even death. When surgical valve repair is necessary for this population, families incur vast expenses to travel to the mainland United States due to …