A Study of Pattern of Cardiac Valvular Involvement in Patients With Rheumatic Heart Disease by Using 2-D Echocardiography

Abstract

BACKGROUND Rheumatic Heart Disease is estimated to affect more than 15 million people worldwide and leads to 2,30,000 deaths every year. 1 More than 80% of children younger than 15 years of age grow up in the regions of the world where RHD is endemic. 2 In developing countries the course is more violent with severe valvular pathological lesions necessitating surgery in young children. 3 METHODS A total of 550 patients attending Subharti Medical College with confirmed valvular heart disease were studied for a period of 1 year using clinical and echocardiographic examination. 350 of these patients had rheumatic heart disease as the aetiology of valvular disease. RESULTS In this study, we used clinical and echocardiographic examination over a period of 1 year and evaluated 550 patients with confirmed valvular heart disease 350 of whom were diagnosed to have rheumatic heart diseases (RHD). 57.14% of these were females and the majority (26.28%) were in the age group of 16-20 years at the time of diagnosis. Our study also revealed that a vast majority of these patients (291) had mitral valve involvement (83.14%) of which 226 patients had isolated mitral stenosis (64.57%). The pulmonary valve was the least affected of all (1.71%). There were no patients with pure tricuspid stenosis. Tricuspid regurgitation (2.28%), pulmonary regurgitation (1.71%). Left sided lesions were far more common with pure MS (64.57%), pure MR (7.14%) and isolated AR and AS at 1.43% and 8.86%, respectively. The mixed valvular lesions were 14%. CONCLUSIONS Rheumatic heart disease was found to be more prevalent in females in the age group 16-20 years and involving the left side of heart more commonly. Involvement of the mitral valve was found in the majority of these patients.