Severe Rheumatic Heart Disease in an Urban Adult Patient Population

Abstract

Aim: To identify the ethnicity and age of patient groups with severe Rheumatic Heart Disease (RHD) presenting to an urban public adult hospital or clinic setting in South East Queensland (MetroSouth) and whether valvular interventions (valve replacement, repair or valvotomy) have been performed. Method: Patients with severe RHD were identified by retrospectively searching the hospital Echocardiography data management system from the period 2007–2018. RHD severity was based on cardiologist interpretation. Patients were grouped according to Indigenous status and country of birth. Results: A total 538 patients with RHD were identified, 43% (n = 229) had severe valvular disease. In the Indigenous Australian group, 38% (n = 21) of patients had severe RHD (mean age 49 yrs) and 43% of these patients had undergone valvular interventions. Forty one percent (n = 87) of Australian-born Non-Indigenous patients had severe RHD (mean age 66 yrs) and 76% had received valvular interventions. In the New Zealand and Pacific Islander group, 51% (n = 52) of RHD patients had severe disease (mean age 49yrs) and 79% had undergone valvular procedures. In contrast, the Asian born group had severe RHD in 34% (n = 23) of cases (mean age 52 yrs) and 83% had undergone interventions. Conclusion: Severe RHD was identified in all ethnic groups at similar rates. All ethnic groups had high rates of valvular interventions except the Indigenous Australian group which has a lower rate. Our results may reflect the nature of healthcare services provided and migration patterns.