Pattern of Valvular Involvement in Rheumatic Heart Disease Patients in a Tertiary Care Hospital of Western Nepal

Abstract

Background and Amis: Rheumatic Heart Disease (RHD) is among the commonest diseases of young adults in low-income countries like Nepal. Mitral and aortic valves are more commonly affected than others in RHD. Echocardiography is simple and cost effective tool to identify the patterns of valvular involvement that helps in diagnosis and determines the timing of surgery. This study aimed at determining the pattern of RHD in patients who underwent Echocardiography in a tertiary care hospital of western Nepal.Methods: A retrospective analysis of trans-thoracic echocardiographic record of patients from January 2009 to December 2015 was done. Data were collected in a pre-structured proforma and analyzed.Results: Among 12567 echocardiography, 609 (4.84%) were recorded to have RHD including post valve replacement patients. Females predominated with male to female ratio of 1:2.8. Most patients, 308 (50%) belonged to age group of 21-40 years. The commonest isolated lesion was mitral regurgitation (MR) in 119 (26.21%) patients followed by mitral stenosis (MS) in 31(6.82%) patients. The commonest mixed lesion was MS with MR and aortic regurgitation (AR) seen in 99 (21.8%). The frequency of atrial fibrillation (AF) and stroke was 18% and 3% respectively in RHD patientsConclusions: The proportion of RHD was high in our study. Majority of RHD patients were females of reproductive age group. The commonest lesion was MR followed by mixed valvular lesions.Nepalese Heart Journal 2016; 13(2): 29-31

Pattern of rheumatic heart disease in Western Rajasthan- an echocardiographic study: a single centre experience

“…RHD was most common in age group 21-40 years and females were more commonly involved than males. These finding correlated with observations of Manjunath et al and Kafle et al 18,19 Manjunath et al observed that majority of patients of valvular heart disease (64.3%) were due to RHD. 18 The pattern of association of valve involvement in RHD was mitral followed by aortic, tricuspid, and pulmonary.…”

Rheumatic Heart Disease among Patients with Valvular Heart Disease Admitted to the In-patient Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study

“…Similar reports were shown in studies done in Nepal where MS was the most common valvular heart lesion in RHD. 9 , 10 Surgical pathology data have demonstrated rheumatic involvement in over 99 percent of excised stenotic valves, 20 , 21 which is consistent with the findings of a vast necropsy series (100%). 22 Congenital MS, which occurs in around 1% of cases, is uncommon in adults since the median age at death is only 2 months.…”

“… 6 , 8 Similar findings were found in a study done in Nepal. 9 , 10 Consistent patterns of valve disease distribution reveal that older age is an independent determinant of all types of valve disease that occur often in the elderly, supporting the assumption that the burden of valve illness rises with age.…”

Pattern of rheumatic heart disease in patients admitted at tertiary care centre of Nepal

“…Similarly, in the study of Kafle RC et al 50% of the patients belonged to age group 21-40 years. 12 Geographical distribution of RHD In this study majority of the admitted patients were from Central Development Region followed by Western and Eastern Development Region The main reason for this might be easy availability of health services and transportation facilities, awareness about the disease among the people and high population density. Least number of patients were admitted from Far Western Region; however, this does not mean that the prevalence of RHD is less in this region.…”