Background and Aims: Rheumatic Fever, Rheumatic Heart Disease and Congenital Heart disease are the most common cardiac problems in school children. Prior studies have reported different prevalence rate of Rheumatic Heart Disease among different groups of population of Nepal. The aim of this study was to estimate the prevalence of Rheumatic Fever, Rheumatic Heart Disease and Congenital Heart Disease among school children in Kathmandu Valley of Nepal. Methods: Cardiac screening of 34,876 school children from 115 randomly selected public schools from two cities of Kathmandu Valley (Kathmandu and Lalitpur) was done. Cases with abnormal findings in auscultation underwent echocardiography and the diagnosis was confirmed. Results: The prevalence of Congenital Heart Disease was noted to be 1 per thousand and prevalence of Rheumatic Heart Disease was found to be 0.90 per thousand (in the age group 5-16 years) with the most common lesion being Mitral Regurgitation. No significant statistical difference was noted between male and female students in both the cases of Rheumatic Heart Disease and Congenital Heart Disease. No cases of Acute Rheumatic Fever were noted. Conclusion: The prevalence of Rheumatic Heart Disease among school children in Kathmandu valley was noted to be lower than reported in similar previous studies. Primary and secondary prevention programs of RF/RHD have been effective in Nepal and are needed to be strengthened and expanded to further reduce the burden of these diseases. Nepalese Heart Journal | Volume 10 | No.1 | November 2013| Pages 1-5 DOI: http://dx.doi.org/10.3126/njh.v10i1.9738

Coronary artery disease (CAD), predominately manifest in older individuals, is a devastating disease precisely because an otherwise healthy person in the prime of life may die or become disabled without warning. When the afflicted individual is under the age of 40, the tragic consequences for family, friends, and occupation are particularly catastrophic and unexpected. Fortunately, the incidence of myocardial infarction (MI) and symptomatic CAD in young adults is low; most studies show that only about 3% of all CAD cases occur in this age range. Premature CAD is defined as cardiac events occurring before the age of 45 in men and 55 in women. In its severe form it is defined as CAD occurring below the age of 40 years. Prematurity and severity suggests that the disease starts at an early age and has a malignant course. In this study, we aim to investigate the major risk factor (smoking, Hypertension, Diabetes and dyslipidemia ) as defined by ACC-AHA pattern in ACS patient 40years or below admitted in Shahid Gangalal National Heart Centre (SGNHC) from April 2008 to April 2009. There were all together 54 ACS patients, male 44(81%) and female 10(19%). HTN is the risk factor which was more commonly diagnosed and treated, while Dyslipidemia, DM and IFG were not usually diagnosed in young patient before they were diagnosed CAD. Dyslipidemia was the most common comprising 83.3% followed by HTN 70%, smoking 70%, abnormal blood glucose level 50%, DM in 22.2% while IFG in 27.7 %. High total cholesterol (48%) is the common form of dyslipidemia followed by high LDL (44.4%), low HDL in 31.4%. When non modifiable risk factor family history is excluded, 85% of the patients have two or more risk factors of CAD. When smoking along with family history is excluded 94.5% of the patients have 1 or more risks factors for CAD.

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