Rheumatic Heart Disease - RANZCOG · Rheumatic Heart Disease . A National (international)...
Transcript of Rheumatic Heart Disease - RANZCOG · Rheumatic Heart Disease . A National (international)...
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Rheumatic Heart Disease A National (international) Perspective
Graeme Maguire Cairns Clinical School School of Medicine & Dentistry James Cook University
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• 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
Rheumatic Heart Disease A National (international) Perspective
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What is it Group A streptococcal infection
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What is it Acute rheumatic fever
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What is it Rheumatic heart disease
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What is it Rheumatic heart disease
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What is it Rheumatic heart disease
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What causes it
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What causes it
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Under the right conditions a proportion of people in any population can be at risk of ARF/RHD
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Population at risk
GAS colonization
GAS pharyngitis
ARF
RHD
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Population at risk
GAS colonization
GAS pharyngitis
ARF
RHD
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02000400060008000
1000012000140001600018000
Burden of disease (years of life lost (YLL) + years of life of disability (YLD) - Aboriginal &
Torres Strait Islander peoples - 2003
How much is around?
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• 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
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• 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? 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
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Because ARF/RHD is preventable and the consequences can be
severe
So why do we worry about a relatively rare condition?
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Population at risk
GAS colonization
GAS pharyngitis
ARF
RHD
Stopping it
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Stopping it
Population at risk
GAS colonization
GAS pharyngitis
ARF
RHD
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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
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• 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
Rheumatic Heart Disease A National (international) Perspective
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Why’s it important to you?
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How much is around? Rheumatic heart disease
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0 - 10 10 - 20 20 - 30 30 - 40 40 - 50 50 - 60 60 -70 70 -80 80 - 90 ALL
% o
f A
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Age group (yrs)
MALES
FEMALES