Echocardiographic screening for early detection of rheumatic heart disease in schools Rheumatic heart disease (RHD) develops as a long term complication of childhood streptococcal angina. Latent RHD can be detected with echocardiography years before it becomes symptomatic. RHD is curable when treated early with medication. RHD is responsible for over 300 000 deaths worldwide each year, accounting for just over two-thirds of all deaths from valvular heart diseases. RHD is disproportionally prevalent across sub-Saharan Africa, South Asia and the Pacific Islands and largely a phenomenon of marginalized communities in developing and emerging countries whereas it disappeared mostly in developed countries like Switzerland.