rheumatic heart disease - ranzcog · rheumatic heart disease . a national (international)...

Rheumatic Heart Disease A National (international) Perspective

Graeme Maguire Cairns Clinical School School of Medicine & Dentistry James Cook University

• What is it and what causes it

• How much is around (especially in women)

• Stopping it (especially as a problem in pregnancy)

• RHD in pregnancy


What is it Group A streptococcal infection

What is it Acute rheumatic fever

What is it Rheumatic heart disease

What causes it

Under the right conditions a proportion of people in any population can be at risk of ARF/RHD

Population at risk

GAS colonization

GAS pharyngitis

ARF

RHD

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Burden of disease (years of life lost (YLL) + years of life of disability (YLD) - Aboriginal &

Torres Strait Islander peoples - 2003

How much is around?

• Extremely rare overall

BUT •Aboriginal and Torres Strait Islander children (5-14 yo) highest documented rates in the world 250-300/100 000/yr (one case for every 300 kids every year)

• ½ million cases of ARF/yr globally

How much is around? Acute rheumatic fever

• Extremely rare overall BUT

• 1-2% of Aboriginal and Torres Strait Islander peoples

• 16 million people living with RHD globally

How much is around? Rheumatic heart disease

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How much is around? Why more in women?

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• More GAS infection

• Accelerated disease

• Greater diagnosis/access

Because ARF/RHD is preventable and the consequences can be

severe

So why do we worry about a relatively rare condition?

Population at risk

GAS colonization

GAS pharyngitis

ARF

RHD

Stopping it

Stopping it

Population at risk

GAS colonization

GAS pharyngitis

ARF

RHD

Stopping it

• RHD is rarely a reason for not getting pregnant BUT planning (and possibly treatment) before pregnancy is the key

• Preventing it – primary and secondary prevention

• Fertility planning/contraceptive advice in women with RHD is EVERYONE’S business

• What is it and what causes it

• How much is around (especially in women)

• Stopping it (especially as a problem in pregnancy)

• RHD in pregnancy


Why’s it important to you?


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rheumatic heart disease - ranzcog · rheumatic heart disease . a national (international)...

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