Oral Presentation 20th Lancefield International Symposium on Streptococci and Streptococcal Diseases 2017

Rheumatic Heart Disease: Morbidity and Long Term Sequelae, Auckland Hospital, New Zealand 2012 (#16)

Kate Jardine 1 , Rachel Webb 2 , Miriam Wheeler 3 , Nigel Wilson 1
  1. Paediatric Cardiology, Starship Children's Hospital , Auckland, New Zealand
  2. Paediatric Infectious Diseases, Starship Children's Hospital, Auckland, New Zealand
  3. Adult Cardiology, Auckland District Health Board (ADHB), Auckland, New Zealand

Background/Aims: Unlike acute rheumatic fever (ARF), there is a lack of comprehensive national surveillance in New Zealand (NZ) for Rheumatic Heart Disease (RHD). The epidemiology, morbidity, mortality and costs of RHD are incompletely understood. We aimed to describe hospitalisations for RHD among patients aged 5 – 45 years admitted to Auckland City Hospital in 2012. We also sought to identify patients presenting with established RHD as compared to ARF.

Methods: Retrospective study of patients aged 5 - 45 years admitted to ADHB in 2012 with RHD. Cases identified via ICD codes for RHD (I05 – I09). A detailed review of clinical, echocardiographic and laboratory records was performed.

Results: 144 hospitalisations in 104 individuals. Median age was 15 yrs. 54% were female. 96% were Pacific or Māori. 81% were NZ residents; 19% were from Pacific Islands nations. Common admission themes were for RHD surgery (74/144, 51%), congestive cardiac failure (45/144, 31%), arrhythmia (33/144, 23%), pre-operative investigations (23/144, 16%), and complications of pregnancy (10/144, 6.7%). There were 4 thromboembolic events, 3 episodes of endocarditis and 1 RHD-related death. 12/104 (12%) patients hospitalised in 2012 presented with newly diagnosed RHD without prior history of ARF and 42/104 (40 %) of the patients in the study had no prior documented history of ARF.

Conclusions: This study highlights the complications and substantial morbidity among young people with RHD in New Zealand. 40% of those studied had no prior diagnosis of ARF, highlighting the importance of early detection of RHD within New Zealand's ARF/RHD control programme.