Nandra Taran Kaur, Wilson Nigel J, Artrip John, Pagis Bruno
Medicine, King's College London, London, UK.
Auckland City Hospital, Auckland, New Zealand.
BMJ Case Rep. 2017 Mar 10;2017:bcr2016218954. doi: 10.1136/bcr-2016-218954.
Rheumatic heart disease (RHD) has a worldwide prevalence of 33 million cases and 270 000 deaths annually, making it the most common acquired heart disease in the world. There is a disparate global burden in developing countries. This case report aims to address the minimal RHD coverage by the international medical community. A Tahitian boy aged 10 years was diagnosed with advanced heart failure secondary to RHD at a local clinic. Previous, subtle symptoms of changes in handwriting and months of fever had gone unrecognised. Following a rapid referral to the nearest tertiary centre in New Zealand, urgent cardiac surgery took place. He returned home facing lifelong anticoagulation. This case highlights the RHD burden in Oceania, the limited access to paediatric cardiac services in countries where the RHD burden is greatest and the need for improved awareness of RHD by healthcare professionals, and the general public, in endemic areas.
风湿性心脏病（RHD）在全球范围内的患病率为3300万例，每年导致27万人死亡，使其成为全球最常见的后天性心脏病。发展中国家面临着截然不同的全球负担。本病例报告旨在探讨国际医学界对风湿性心脏病的最低覆盖情况。一名10岁的塔希提岛男孩在当地诊所被诊断为继发于风湿性心脏病的晚期心力衰竭。此前，他书写变化的细微症状以及持续数月的发热都未被察觉。在迅速转诊至新西兰最近的三级医疗中心后，他接受了紧急心脏手术。他回国后面临终身抗凝治疗。本病例凸显了大洋洲的风湿性心脏病负担、在风湿性心脏病负担最重的国家儿科心脏服务获取有限，以及在流行地区医疗专业人员和公众提高对风湿性心脏病认识的必要性。
