Clinical Profile and Management in Children with Rheumatic Heart Disease in a Tertiary Cardiac Care Center of Nepal

Sharma, Poonam; Shakya, Urmila; Kc, Sunita; Shrestha, Manish

doi:10.3126/njh.v13i2.15562

Cited by 6 publications

(15 citation statements)

References 13 publications

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“…Atrial fibrillation occurred more often in the young adult population and was particularly significant given its debilitating complication of spontaneous thrombosis LA, along with limited access to anticoagulants in rural areas (1,8). Infective endocarditis (IE) was also detected in the child population, which was in accordance with a previous study in which IE was observed in 16% children with RHD (3). RHD was found to be the cause of 84% cases of IE, specifically in Asian countries (3,11).…”

Section: Clinical Manifestations and Reactivation Of Rhd In Children supporting

confidence: 90%

“…Infective endocarditis (IE) was also detected in the child population, which was in accordance with a previous study in which IE was observed in 16% children with RHD (3). RHD was found to be the cause of 84% cases of IE, specifically in Asian countries (3,11). This association was potentially fatal, considering that IE is challenging to diagnose and manage, especially with limited diagnostic support.…”

Section: Clinical Manifestations and Reactivation Of Rhd In Children supporting

confidence: 87%

“…Chorea was seen only in the young adult population, frequently affected the face asymmetrically, and rarely occurred as a sole manifestation. A previous study, however, had reported a prevalence of chorea in 1.4% cases among 211 children in Nepal (3). Fever was the second most common clinical manifestation in both groups, followed by a rise in inflammatory markers.…”

Section: Clinical Manifestations and Reactivation Of Rhd In Children mentioning

confidence: 65%

“…Rheumatic fever (RF) usually affects school-age children, with preceding infection of group A streptococcus (GAS) that manifests in multiple symptoms. Risk factors of streptococcal infection include poverty, malnutrition, overcrowding, poor housing, and shortage of healthcare resources, underlining the high prevalence in developing countries (1,3). All manifestations of RF resolve completely after, except for cardiac valvular lesion, which is the hallmark of RHD.…”

Section: Introductionmentioning

confidence: 99%

“…All manifestations of RF resolve completely after, except for cardiac valvular lesion, which is the hallmark of RHD. Postrheumatic valvulopathies remain the main cause of heart failure among children and young adults (3). Therefore, patients with clinical features of RF/RHD should be promptly treated and referred for definite diagnosis and long-term management to limit the extent of heart damage.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Profile and Management of Rheumatic Heart Disease in Children and Young Adults at a Tertiary Cardiac Center in Indonesia

et al. 2020

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Introduction: Rheumatic heart disease (RHD) remains a major public health issue affecting children and young adults in developing countries. This study aimed to evaluate the clinical characteristics, management, and reactivation of RHD among children and young adults. Patients and Methods: This was a hospital-based retrospective study conducted at the National Cardiovascular Center Harapan Kita, Indonesia; we retrieved relevant data from patients diagnosed with RHD between 2012 and 2018. Results: Two hundred and seventy-nine patients were diagnosed with rheumatic heart disease, of whom 108 were children (mean age of 12.02 ± 3.36 years) and 171 were young adults (mean age was 24.9 ± 3.84). RHD was more common in female than in male young adults (1.5:1). Hospitalization due to RHD complications such as congestive heart failure was seen in 11.11% of cases in children, while pulmonary hypertension was present in 19.95% young adult cases. Reactivation of RHD occurred in 17.2% (48/279) cases, significantly in children (p < 0.001). Overall, the mitral valve (either isolated or combined) was the organ most affected in children (39.13%) and young adults (44.81%). Isolated mitral regurgitation was more common in children (13/21, 61.9%), while isolated mitral stenosis was more common in young adults (19/47, 40.42%). There was a high rate of rheumatic tricuspid valve disease in all populations (193/279, 69.17%) and reported involvement of pulmonary regurgitation (46/279, 16.48%). Multivalve lesions were more common than single lesions in both groups, with a combination of mitral and tricuspid regurgitation the predominant type in children (32/43, 74.41%) and mixed mitral lesion and tricuspid regurgitation in young adults (22/72, 30.56%). We observed a significant occurrence of quadrivalve lesions in children (p = 0.039). Valve repair was more common in children (49.07%) and replacement in young adults (32.16%), with low in-hospital mortality. Compliance with secondary prophylaxis was a significant challenge. Conclusion: Chronic RHD often presented with complications of the disease or reactivation of rheumatic fever (RF). Inadequate treatment of RF/RHD leads to extensive valvular damage and consequent disabilities. Efforts toward active early diagnosis and prompt treatment of RF/RHD and effective preventive measures are essential.

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Section: Clinical Manifestations and Reactivation Of Rhd In Children supporting

confidence: 90%

Section: Clinical Manifestations and Reactivation Of Rhd In Children supporting

confidence: 87%

Section: Clinical Manifestations and Reactivation Of Rhd In Children mentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Profile and Management of Rheumatic Heart Disease in Children and Young Adults at a Tertiary Cardiac Center in Indonesia

et al. 2020

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Acquired heart disease in children is not necessarily rheumatic

Neha

Taneja²

2019

Trop Doct

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Acquired heart diseases (AHD) cause significant morbidity and mortality in children. There are limited studies on their burden in children. We conducted a retrospective study of 85 consecutive children diagnosed with AHD using clinical evaluation and echocardiography at Medical College, Kanpur, India to determine the aetiology and outcome of AHD in children. We found rheumatic heart disease (RHD) in one-third, cardiomyopathies or myocarditis combined in a further third and the remaining third were other causes, including pericardial diseases and metabolic or genetic disorders. These latter diseases were frequently misdiagnosed, causing significant morbidity and mortality. Hence, in children of all age groups presenting with unexplained shock, dyspnoea, hepatomegaly and ascites, cardiac status should be carefully and critically evaluated so that non-rheumatic AHD may not be missed.

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Clinical and Socio-Demographic Profiles of Patients Seen with Rheumatic Heart Disease in a Cardiac Clinic of a Tertiary Hospital in Ghana

Owusu¹,

Ameyaw²,

Wiafe³

2022

RRCC

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Background: Rheumatic heart disease (RHD) is mainly among populations in low-to-middle income nations. The burden of this disease on communities and even hospital settings is little understood. This study aimed at analysing the clinical and sociodemographic features of RHD patients in our adult outpatient cardiac department over a 3-year period. Methods: The study was conducted at the Komfo Anokye Teaching Hospital's Adult Cardiac Clinic in Kumasi, Ghana. Medical records of patients seen at the adult cardiac clinic between 2016 and 2019 with the diagnosis of rheumatic heart disease were examined. The data were captured using EPI-DATA (version 3.1). Stata 14 was used in analysing the mean (standard deviation) and median of continuous variables (inter-quartile range). The frequency and percentages were used to describe categorical data. The Chisquare test was used to establish the statistical significance of a relationship, with a p-value of less than 0.05. Results: A total of 140 RHD cases were included in the study. The average age of patients was 39.7 years. Majority of the participants (82.9%) were from rural areas. Palpitation was the commonest symptom (54.29%), followed by chest pains (36.43%), dyspnoea (25.00%), and dizziness (24.29%). Over seventy-seven percent (77.14%) of the patients had moderate-to-severe rheumatic heart disease. The commonest valvular lesion was isolated mitral regurgitation (56.43%), followed by pure aortic regurgitation (30.71%), and isolated tricuspid regurgitation (12.14%). Conclusion: RHD occurred more commonly in the third decade of life. Rural participants, who are primarily females, were the most affected. Efforts to reduce prevalence rates should be stepped up.

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Clinical Profile and Management in Children with Rheumatic Heart Disease in a Tertiary Cardiac Care Center of Nepal

Cited by 6 publications

References 13 publications

Clinical Profile and Management of Rheumatic Heart Disease in Children and Young Adults at a Tertiary Cardiac Center in Indonesia

Clinical Profile and Management of Rheumatic Heart Disease in Children and Young Adults at a Tertiary Cardiac Center in Indonesia

Acquired heart disease in children is not necessarily rheumatic

Clinical and Socio-Demographic Profiles of Patients Seen with Rheumatic Heart Disease in a Cardiac Clinic of a Tertiary Hospital in Ghana

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