Structural Heart Disease

Authors: David Watkins, Babar Hasan, Bongani Mayosi, Gene Bukhman, Antonio Marin-Neto, Anis Rassi, Junior, Anis Rassi, Krishna Kumar


This chapter summarizes the key clinical and public health issues around three key groups of structural heart disease: major congenital heart defects, rheumatic heart disease (RHD), and Chagas disease (CD). Although advanced surgical care for these conditions continues to evolve rapidly, an acute need for primary prevention and early detection exists in many programs. These activities have particular relevance in resource-constrained settings, where access to advanced surgical and interventional care remains unfeasible. Structural heart diseases prove unique because they predominantly affect younger populations and thus contribute substantially to the years of life lost from cardiovascular disease in lower- and middle-income countries (LMICs). Preventive measures exist for all three conditions and prove most effective for RHD and CD. A growing Interest in screening programs exists for structural heart diseases, yet the role of screening remains limited in settings where access to advanced medical and surgical care remains unavailable. Recommendations for prevention and management require contextualization to individual settings and integration into broader cardiovascular disease control policy frameworks.