Cardiovascular imaging modalities in the diagnosis and management of rheumatic heart disease.

Rheumatic heart disease (RHD) is prevalent in sub-Saharan Africa, where the capacity for diagnosis and evaluation of disease severity and complications is not always optimal. While the medical history and physical examination are important in the assessment of patients suspected to have RHD, cardiovascular imaging techniques are useful for confirmation of the diagnosis. Echocardiography is the workhorse modality for initial evaluation and diagnosis of RHD. Cardiovascular magnetic resonance is complementary and may provide additive information, including tissue characteristics, where echocardiography is inadequate or non-diagnostic. There is emerging evidence on the role of computed tomography, particularly following valve replacement surgery, in the monitoring and management of RHD. This article summarises the techniques used in imaging RHD patients, considers the evidence base for their utility, discusses their limitations and recognises the clinical contexts in which indications and imaging with various modalities are expanding. • Diagnosis of RHD is based on medical history and physical examination; echocardiography is the first-line imaging modality. • Cardiovascular imaging techniques aid with diagnosis and comprehensive evaluation of severity and complications in RHD. • CT and CMR provide additive information above echocardiography but are not always available in resource-poor settings. • Improved understanding of the role of imaging modalities and their complementary role enhances management of RHD patients. [ABSTRACT FROM AUTHOR]