About 13 percent of the 650 school children in American Samoa screened by a cardiology team from Oregon Science and Health University have some evidence of rheumatic heart disease.
Team leader Dr Erin Madriago says this is a higher prevalence rate than they predicted and also higher than what is found in other parts of the Pacific.
Dr Madriago, an assistant professor and director of Echocardiography at Doernbecher Children's Hospital, is on an island studying the prevalence of rheumatic heart disease in healthy school
Rheumatic heart disease is the most common acquired heart disease in children especially in developing countries. Dr Madriago explains that rheumatic heart disease is a culmination of several factors.
"It's kids getting strep infections and then ultimately they develop rheumatic fever and then it starts to attack their valves and they develop rfheumatic heart disease and their valves weaken and they become thickened and can't open as well and after often repeated exposure, repeated problems with this, they can develop heart failure and need to have a heart transplant."
Dr Erin Madriago