Rheumatic fever is a focus for a visiting medical team in American Samoa.
The team from Oregon Health Sciences University says it's important to detect and treat the disease early on.
The LBJ Hospital does not have a doctor with training to conduct ultrasounds of children's hearts, but has the Pacific's highest rate of children with rheumatic heart disease.
12 percent of 1000 school children, who were tested using World Health Organisation guidelines, were found to have rheumatic fever which leads to rheumatic heart disease.
The Oregon Health Sciences University has been sending medical teams to help identify and treat children with rheumatic fever for five years.