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Prevention of Acute Rheumatic Fever and Rheumatic Heart Disease by Mariana Mirabel, Kumar Narayanan, Xavier Jouven, and Eloi Marijon Circulation Volume 130(5):e35-e37 July 29, 2014 Copyright © American Heart Association, Inc. All rights reserved. Rheumatic mitral stenosis. Mariana Mirabel et al. Circulation. 2014;130:e35-e37 Copyright © American Heart Association, Inc. All rights reserved. In a low-income Caribbean Island, Santa Lucia, success was achieved by reori enting part of the budget allocated to cardiac surgery to an acute rheumatic fever (ARF)/rheumatic heart disease (RHD) control program including primary and secondary prophylaxis. Mariana Mirabel et al. Circulation. 2014;130:e35-e37 Copyright © American Heart Association, Inc. All rights reserved. Early detection by hand-held ultrasound screening and antibiotic prophy laxis have the potential to successfully eliminate the scourge of rheumatic heart disease (RHD) from the developing world. Mariana Mirabel et al. Circulation. 2014;130:e35-e37 Copyright © American Heart Association, Inc. All rights reserved.