Reasonable Hypothesis SOP [1] | 51 of 2019 |
Balance of Probabilities SOP [2] | 52 of 2019 |
SOP Bulletin 208 [3]
Rheumatic heart disease is chronic damage to the heart, particularly the heart valves, due to acute rheumatic fever in the past.
The diagnosis may be suspected in someone with a history of acute rheumatic fever and with a heart murmur. Confirmation of diagnosis generally requires echocardiography, showing characteristic morphologic features.
The relevant medical specialist is a cardiologist.
*another SOP applies
The latency from initial infection (acute rheumatic fever) to first manifestation of chronic heart disease can range from months to decades. In a significant proportion of cases there will be no known history of prior rheumatic fever, due to the condition being sub-clinical, or not detected. Onset of rheumatic heart disease is most often between ages 20 to 50 but can be earlier or later. Clinical manifestations vary with the valves or other structures involved and with the severity of involvement, but dyspnoea (shortness of breath), exertional dizziness, or arrhythmia (atrial fibrillation) may be present and a heart murmur may be heard.
The course of the condition is variable. More severe cases can progress to heart failure or the need for surgical intervention for damaged valves. Appropriate treatment, including prevention of new heart infection, can limit progression.
Place holder node for Rulebase for rheumatic heart disease
Rheumatic heart disease - Inability to obtain appropriate clinical management for rheumatic heart disease Factor
Last reviewed for CCPS 03 October 1995.
Investigative Documents
Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM] Preliminary questions [32598] 11109 — the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.
7334 [6] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service. the condition under consideration permanently worsened. the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.
7379 [9] the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration. 11234 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration. 11235 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration. or 11236 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration. Clinical worsening and operational service [11235] or 7390 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service. [14] [15] Clinical worsening and eligible service [11236] or 7391 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service. [14] [15]
Rheumatic heart disease - Rheumatic fever Factor
Last reviewed for CCPS 03 October 1995.
Preliminary questions [11408]
103 [22] the veteran has had rheumatic fever at some time.
11309 — rheumatic fever means a febrile disease occurring as a delayed sequela of infections with group A beta-hemolytic streptococci and characterised by multiple focal inflammatory lesions of connective tissue especially involving the heart, blood vessels and joints with resultant arthritis, chorea, or carditis appearing alone or in combination, and attracting ICD codes 390, 391, or 392. [Default true]
11321 [23] the veteran suffered from the identified illness or injury, a type of rheumatic fever, before the clinical onset of the condition under consideration. [24]
11313 — the veteran has established the causal connection between the identified illness or injury, a type of rheumatic fever, and VEA service for the clinical onset of the condition under consideration.
11317 — the veteran has established the causal connection between the identified illness or injury, a type of rheumatic fever, and operational service for the clinical onset of the condition under consideration.
or
11318 — the veteran has established the causal connection between the identified illness or injury, a type of rheumatic fever, and eligible service for the clinical onset of the condition under consideration.
Clinical onset and operational service [11317]
11323 — the identified illness or injury, a type of rheumatic fever, is causally related to operational service. [25] [26]
Clinical onset and eligible service [11318]
11324 — the identified illness or injury, a type of rheumatic fever, is causally related to eligible service. [27] [26]
Rheumatic heart disease - Streptococcal A infection on service Factor
Last reviewed for CCPS 03 October 1995.
Investigative Documents
Medical Report - Streptococcal A Infection [MR9056] Preliminary questions [11409] 11413 — the veteran has established the causal connection between the streptococcal A infection and operational service for the clinical onset of the condition under consideration. Clinical onset and operational service [11413]
Links
[1] http://www.rma.gov.au/assets/SOP/2019/051.pdf
[2] http://www.rma.gov.au/assets/SOP/2019/052.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20208.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/64070%23comment-form
[5] https://clik.dva.gov.au/ccpsother-31
[6] https://clik.dva.gov.au/node/68700
[7] clikpopup://CCPS/Reject/OnsetAfterService
[8] clikpopup://CCPS/Reject/NoPermanentWorsening
[9] clikpopup://CCPS/Rheumatic heart disease/ACM - contributed to worsening
[10] clikpopup://CCPS/ACM/NoContribution
[11] clikpopup://CCPS/ACM/NotOpService
[12] clikpopup://CCPS/ACM/NotOperDuties
[13] clikpopup://CCPS/rejectwilful
[14] clikpopup://CCPS/ACM/NoIllness
[15] clikpopup://CCPS/reject7390,7391No
[16] clikpopup://CCPS/Rheumatic heart disease/ACM - onset prior to operational service
[17] clikpopup://CCPS/ACM/OnsetFailOper
[18] clikpopup://CCPS/ACM/NotEligService
[19] clikpopup://CCPS/ACM/NotEligDuties
[20] clikpopup://CCPS/Rheumatic heart disease/ACM - onset prior to eligible service
[21] clikpopup://CCPS/ACM/OnsetFailElig
[22] https://clik.dva.gov.au/standard-commentary-3
[23] https://clik.dva.gov.au/rheumatic-fever
[24] clikpopup://CCPS/reject11321No
[25] clikpopup://CCPS/reject11323No
[26] clikpopup://CCPS/reject11323,11324No
[27] clikpopup://CCPS/reject11324No
[28] https://clik.dva.gov.au/ccpsmedical-163
[29] clikpopup://CCPS/reject11414No
[30] clikpopup://CCPS/reject11412No