Although there are many social problems in patients with rheumatic heart disease (RHD) due to chronic physical disability, the prophylaxis of RHD in the adult has not been established. Some reasons are that the natural history of rheumatic fever (RF) and RHD is not known in adults as in children, and that studies on adult RF are few in the world
1)-6). From the point of prophylaxis, it is important to make clear what kind of disadvantages will such patients and their families have in social life. And it is necessary to clarify the character of acute RF and RHD in the adult.
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