Acute Congestive Heart Failure in a Young Woman

Abstract

We describe the case of an adult First Nations woman employed as a daycare worker who presented with clinical symptoms, signs, and imaging suggestive of acute heart failure. In our report, we discuss the likely diagnosis of acute rheumatic fever. Novel teaching points: The incidence of rheumatic fever in Canada is likely underestimated, and it is important to consider the diagnosis of acute rheumatic fever in individuals presenting with acute heart failure. More research is needed in Canada to further identify groups most at risk for developing this disease.

Access to Cardiovascular Care for Indigenous Peoples in Canada: A Rapid Review

“…In addition to the incorporation of indigenous medicine into the management of Indigenous peoples with CVD, contextual guidelines must be formulated for the management of CVDs. 54 For example, rheumatic heart disease has become rare in Canada, although it is still prevalent among Indigenous peoples; yet, health workers are unfamiliar with the condition—specifically, it is not a reportable illness, and disease surveillance by public health authorities remains limited. 55 Without contextual guidelines and practice recommendations, delays in the diagnosis and delivery of care may persist, worsening long-term outcomes for patients presenting with such conditions.…”

“…• Context-specific and culturally appropriate management guidelines: In addition to the incorporation of Indigenous medicine into the management of Indigenous Peoples with CVD, contextual guidelines must be formulated for the management of CVDs (54). For example, rheumatic heart disease has become rare in Canada although still prevalent among Indigenous Peoples; yet, health workers are unfamiliar with the condition, specifically it is not a reportable illness and disease surveillance by public health authorities remains limited (55).…”