Background: Rheumatic heart disease remains a major public health problem in developing countries like India affecting the young population imparting huge familial, social and manpower burden. While acute rheumatic fever is on the decline even in the developing world, there are still a large number of chronic rheumatic heart disease cases, often complicated by chronic congestive heart failure and recurrent thrombo-embolic phenomena, both posing greater challenges for management. We report on the prevalence and pattern of valve involvement in RHD from our centre.
Materials and methods: This is a hospital based descriptive cross-sectional study during December 2013 to January 2016 over a period of 25 months at Sawai Man Singh Medical College, Jaipur including 940 patients with clinical and/ or echocardiographic evidence of definite rheumatic heart disease.
Results: The age of the patients ranged from 8 to 74 years with mean age 39.82 ± 4.2 years with female preponderance (F:M = 2.1:1) (p<0.01). Majority of the rheumatic heart disease patients belonged to 30–44 years (28.78%) followed by 15–29 years (25.75%) and 45–59 years (25.00%). Majority belonged to the low socioeconomic status (60.60%) (p<0.05). The predominantly involved isolated valve was mitral in 440 patients (46.80%) followed by isolated aortic valve in 88 patients (9.36%) and 316 (33.62%) had dual valvular involvement. The common rheumatic valvular lesions were pure mitral stenosis in 128 (13.61%), isolated mitral regurgitation in 232 (24.68%), combined mitral stenosis/regurgitation in 144 (15.32%), combined mitral/aortic regurgitation in 92(9.78%) and combined aortic stenosis/regurgitation in 72 (7.66%) patients with few overlappings. The common
complications encountered were heart failure in 360 (38.30%) and arrhythmias in 496 (51.00%) patients.520 patients (55.32%) received injectable benzathine penicillin whereas 180 patients (19.15%) preferred oral penicillin V. Surgical intervention was done in 216 (22.97%) patients. 48 (5.10%) expired in the CCU during the course of treatment.
Conclusion: RHD is a leading cause of heart failure among young populations with requirement of prolonged duration of medical treatment and many of them requiring surgery.
Impact Factor
2022: 6.012
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