Rheumatic heart disease
Meaning of rheumatic heart disease: For the purposes of this Statement of Principles, rheumatic heart disease: (a) means a clinically or echocardiographically documented cardiac disease, commonly involving the mitral or aortic valve, that follows acute rheumatic fever; and (b) includes pathological stenosis or regurgitation in the presence of scarring, deformity or morphological change of at least one heart valve, chronic rheumatic myocarditis and chronic rheumatic pericarditis; and (c) excludes acute carditis of acute rheumatic fever.
Reasonable Hypothesis (RH) — Statement of Principles No. 51 of 2019
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting rheumatic heart disease or death from rheumatic heart disease with the circumstances of a person's relevant service:
- (1)having acute rheumatic fever at least three months before the clinical onset of rheumatic heart disease;
- (2)having a group A beta-haemolytic streptococcal infection of the skin or the pharynx at least three months before the clinical onset of rheumatic heart disease;
- (3)experiencing crowded living or working conditions at least three months before the clinical onset of rheumatic heart disease;
- (4)having acute rheumatic fever before the clinical worsening of rheumatic heart disease;
- (5)having a group A beta-haemolytic streptococcal infection of the skin or the pharynx before the clinical worsening of rheumatic heart disease;
- (6)experiencing crowded living or working conditions within the ten years before the clinical worsening of rheumatic heart disease;
- (7)being pregnant within the 30 days before the clinical worsening of rheumatic heart disease;
- (8)inability to obtain appropriate clinical management for rheumatic heart disease;
Aggravation-only factors: the factors in subsections 9(4) to 9(8) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
Balance of Probabilities (BoP) — Statement of Principles No. 52 of 2019
8 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, rheumatic heart disease or death from rheumatic heart disease is connected with the circumstances of a person's relevant service:
- (1)having acute rheumatic fever at least three months before the clinical onset of rheumatic heart disease;
- (2)having a group A beta-haemolytic streptococcal infection of the pharynx at least three months before the clinical onset of rheumatic heart disease;
- (3)experiencing crowded living or working conditions at least three months before the clinical onset of rheumatic heart disease;
- (4)having acute rheumatic fever before the clinical worsening of rheumatic heart disease;
- (5)having a group A beta-haemolytic streptococcal infection of the pharynx before the clinical worsening of rheumatic heart disease;
- (6)experiencing crowded living or working conditions within the ten years before the clinical worsening of rheumatic heart disease;
- (7)being pregnant within the 30 days before the clinical worsening of rheumatic heart disease;
- (8)inability to obtain appropriate clinical management for rheumatic heart disease;
Aggravation-only factors: the factors in subsections 9(4) to 9(8) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
