Rheumatic heart disease: current status of diagnosis and therapy

Peters, Ferande; Karthikeyan, Ganesan; Abrams, J. T.; Muhwava, Lorrein Shamiso; Zühlke, Liesl

doi:10.21037/cdt.2019.10.07

Cited by 37 publications

(31 citation statements)

References 67 publications

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“…Rheumatic coronary illness (RHD) being the prevailing type of valvular heart disease in under-developed countries [6]. Acute rheumatic fever and rheumatic heart disease are thought to be the outcome of an autoimmune response, but the precise pathogenesis remains unclear [7]. In this study, out of fifty patients, the majority of study subjects were in the age group of 20-29 years, with a female preponderance of 64% while the mean age was 33.71±6.82 years.…”

Section: Discussionmentioning

confidence: 99%

“…Sani MU et al reported pulmonary hypertension (72.1%) in individuals with rheumatic heart disease [19]. The data suggest that recurrences of RF are higher in patients with RHD and each recurring disease episode further damages the heart [20]. The monitoring of medical therapy because RHD at this stage would warrant lifelong prophylaxis while in order to counter these recurrent attacks effective secondary prevention is required, which relies on accurate case detection for the appropriate use of prophylactic antibiotics and regular medical surveillance whereas the echocardiography plays an important role firstly, in early detection of RHD [21,22].…”

Section: Discussionmentioning

confidence: 99%

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Clinical and Echocardiographic Profile of Rheumatic Heart Disease: A Cross-Sectional Study

Dall

Shaikh

Shah

et al. 2021

JPRI

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Background: Rheumatic Heart disease (RHD) is the leading cause of acquired heart disease and more prevalent in developing countries. The objective of the study was to determine the clinical and echocardiographic profiles of patients with rheumatic heart disease (RHD). Materials and Methods: All patients above the age of 12 years of either gender diagnosed with Rheumatic heart disease from January 2018 to December 2019 at tertiary care hospital, Hyderabad were enrolled in the study. Detailed patient data was obtained from the hospital records. Information regarding gender, age, Electrocardiogram findings, clinical and echocardiographic manifestations was obtained. Results: Throughout the two-year study period, a total of fifty patients with RHD were studied. The mean age of the population was 33.71 years. Females (64%) outnumbered males and 60% were rural population. The clinical features observed were fever (80%), joint pain (64%), palpitation (60%), breathlessness (90%) and chest pain (50%), tachycardia (60%), raised JVP (10%), hypertension (20%). The common echocardiographic findings observed were mitral stenosis (50%), mitral regurgitation (24%) and pulmonary hypertension (36%), left atrial enlargement (56%), and right atrial enlargement (16%) whereas the majority of the patients (70%) have ejection fraction between 40-50% and thrombus was identified in 15 (30%) patients respectively. Conclusion: Common clinical findings observed were breathlessness and fever while the common echocardiographic findings were mitral stenosis and regurgitation, pulmonary hypertension, and left atrial enlargement. Population-based screening by echocardiography could be a potential route for early screening of rheumatic heart disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical and Echocardiographic Profile of Rheumatic Heart Disease: A Cross-Sectional Study

Dall

Shaikh

Shah

et al. 2021

JPRI

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“…Echocardiographic Diagnostic Criteria based on the 2012 World Heart Federation for RHD is categorized into 2 based on age(< 20 years and > 20 years of age). In echocardiographic criteria for paediatric's less than or equal to 20 years is divided into 3 sections definite, borderline and normal echocardiographic findings [12,13] is shown in Table 2. [12,13] is shown in Table 3.…”

Section: Laboratory Testmentioning

confidence: 99%

Rheumatic Heart Disease in Indian Paediatrics: A Review

Vahini

Narenthiran

Chandrasekar

2021

JPRI

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Rheumatic heart disease (RHD) is a condition in which the valves of the heart are damaged, it is mainly caused by Group A Streptococcus, it mainly affects the paediatrics and young adults. Inflammation occurs in the joints, heart and blood vessels due to group A streptococcus. The exact pathogenesis of rheumatic heart disease is unknown. It is manifested as fatigue, chest pain and shortness of breath; pulmonary hypertension, heart failure are some of the complications of the disease. Endocarditis, viral myocarditis and prolapse of the mitral valve are the differential diagnosis of rheumatic heart disease. It is diagnosed by revised Jones and World Heart Federation criteria. Benzylpenicillin is the first-line drug for rheumatic heart disease, followed by oral Penicillin V, Erythromycin can be recommended. Paediatrics who are allergic to Penicillin Azithromycin, Erythromycin can be recommended based on Indian paediatrics and World Health Organization guidelines. It is prevented by reducing the exposure to infection in high-risk regions; treat with appropriate antibiotics; prevent recurrence of infections and complications. The aim of this review is to highlight rheumatic heart disease in paediatric population.

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“…Rheumatic heart disease (RHD) remains a number one cause of preventable cardiovascular diseases (CVDS) [ 1 ]. It is also the major cause of heart disease for children and teenagers in low and middle-income countries and several marginalized groups in developed countries, causing a major health challenge for them [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Rheumatic Heart Disease Screening Based on Phonocardiogram

Asmare

Filtjens

Woldehanna

et al. 2021

Sensors

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Rheumatic heart disease (RHD) is one of the most common causes of cardiovascular complications in developing countries. It is a heart valve disease that typically affects children. Impaired heart valves stop functioning properly, resulting in a turbulent blood flow within the heart known as a murmur. This murmur can be detected by cardiac auscultation. However, the specificity and sensitivity of manual auscultation were reported to be low. The other alternative is echocardiography, which is costly and requires a highly qualified physician. Given the disease’s current high prevalence rate (the latest reported rate in the study area (Ethiopia) was 5.65%), there is a pressing need for early detection of the disease through mass screening programs. This paper proposes an automated RHD screening approach using machine learning that can be used by non-medically trained persons outside of a clinical setting. Heart sound data was collected from 124 persons with RHD (PwRHD) and 46 healthy controls (HC) in Ethiopia with an additional 81 HC records from an open-access dataset. Thirty-one distinct features were extracted to correctly represent RHD. A support vector machine (SVM) classifier was evaluated using two nested cross-validation approaches to quantitatively assess the generalization of the system to previously unseen subjects. For regular nested 10-fold cross-validation, an f1-score of 96.0 ± 0.9%, recall 95.8 ± 1.5%, precision 96.2 ± 0.6% and a specificity of 96.0 ± 0.6% were achieved. In the imbalanced nested cross-validation at a prevalence rate of 5%, it achieved an f1-score of 72.2 ± 0.8%, recall 92.3 ± 0.4%, precision 59.2 ± 3.6%, and a specificity of 94.8 ± 0.6%. In screening tasks where the prevalence of the disease is small, recall is more important than precision. The findings are encouraging, and the proposed screening tool can be inexpensive, easy to deploy, and has an excellent detection rate. As a result, it has the potential for mass screening and early detection of RHD in developing countries.

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Rheumatic heart disease: current status of diagnosis and therapy

Cited by 37 publications

References 67 publications

Clinical and Echocardiographic Profile of Rheumatic Heart Disease: A Cross-Sectional Study

Clinical and Echocardiographic Profile of Rheumatic Heart Disease: A Cross-Sectional Study

Rheumatic Heart Disease in Indian Paediatrics: A Review

Rheumatic Heart Disease Screening Based on Phonocardiogram

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