Abstract:
Over the past decades, South Africa has undergone rapid
demographic changes, which have led to marked increases in
specific cardiac disease categories, such as rheumatic heart
disease (now predominantly presenting in young adults with
advanced and symptomatic disease) and coronary artery
disease (with rapidly increasing prevalence in middle age).
The lack of screening facilities, delayed diagnosis and inadequate
care at primary, secondary and tertiary levels have led
to a large burden of patients with heart failure. This leads to
suffering of the patients and substantial costs to society and
the healthcare system.
In this position paper, the South African Heart Association
(SA Heart) National Council members have summarised
the current state of cardiology, cardiothoracic surgery and
paediatric cardiology reigning in South Africa. Our report
demonstrates that there has been minimal change in the
number of successfully qualified specialists over the last
decade and, therefore, a de facto decline per capita. We
summarise the major gaps in training and possible interventions
to transform the healthcare system, dealing with the
colliding epidemic of communicable disease and the rapidly
expanding epidemic of non-communicable disease, including
cardiac disease.