Pattern of Valvular Involvement in Asymptomatic Chronic Rheumatic Heart Disease

Abstract

Background: Rheumatic Heart Disease (RHD) constitutes the most common form of Valvular heart disease in India. Rheumatic valvulitis most commonly affects the mitral valve (70% to 75%) followed by combined mitral and aortic involvement (20% to 25%), with isolated aortic disease being uncommon (5% to 8%). However no data is available regarding pattern of valvular involvement in asymptomatic chronic rheumatic heart disease. Aims & Objective: To study the pattern of valvular involvement in asymptomatic chronic rheumatic heart disease. Methods: Total no 12862 in the age group of 20 yrs to more than 90 yrs referred for perioperative evalution, preemplyoment check up, preinsurance check up annual routine health check up for general health, evaluation of atrial fibriiation antenatal check up were included in the present studyconducted from April 2005 to January 2018. All were screened by standard routine echocardiography procedure. Results: Out of total no of 12862 persons screened Rheumatic valvular lesion was detected in 2057 persons with max prevalence in age group of 40 to 50 yrs. Mitral valve thickening with mild MR was detected in 42% cases followed by thick mitral valve mild MR mild AR in 14%, thick mitral valve with mild AR in 12%, thick mitral valve with mild MS mild MR mild AR in 8%, thick mitral valve with mod MR mild AR in 8%. Mild MS mild AR in 6% thick aortic valve with mild MR in 6%, moderate AR mild MR in 4% moderate MS mild MR in 4%, mod MS mild MR mild AR in2% severe MR mild AR in 2%. Organic Tricuspid Valve disease was detected in 6% of cases. Conclusion: Routine screening study involving asymptomatic patient evaluated by routine echocardiography revealed high prevalence of regurgitation lesion. Mild to moderate MR along with thick valves is the dominant lesion and stenotic lesion are less prevalent among the asymptomatic persons.