Sequelae of chronic rheumatic heart disease among patients at two teaching hospitals in Sindh, Pakistan

Abstract

OBJECTIVE: To evaluate different sequelae in adult patients of chronic rheumatic heart disease. DESIGN: A descriptive study. SETTING: This study was conducted at Liaquat University Hospital and Isra University Hospital, Hyderabad- Sindh from January 2003 to December 2004. METHODS: Patients of chronic rheumatic heart disease who presented at Liaquat University Hospital and Isra University Hospital were enrolled in the study. Demographic details of patients such as age, sex, socioeconomic status as well as their symptoms such as dysponea, palpitation and chest pain were noted on a proforma. Number of rheumatic fever attacks in the past were also noted. Patients were examined carefully for cardiac valvular lesions and for signs of acute rheumatic fever. Patients underwent different investigations such as blood complete picture, ESR, ASO titre, ECG, X-ray chest, echocardiography and Doppler. All patients had their calcium levels and collagen profile checked to exclude non rheumatic causes of valvular heart disease. RESULTS: One hundred adult patients of chronic rheumatic heart disease were studied for various valvular sequelae. Out of 100 patients studied, 49 (49%) patients were males and 51 (51%) were females. Seventy-three (73%) patients were below 30 years of age (Group A) and 27 (27%) patients were above 30 years of age (Group B). Patients age ranged between 12 and 60 years. Forty-eight (48%) patients had predominant mitral stenosis. Forty-two (42%) patients had predominant mitral regurgitation. Nine (9%) patients had aortic regurgitation and one (1%) had aortic stenosis along with mitral valve disease. CONCLUSION: From this study, it is concluded that mitral valve stenosis is frequently observed than mitral regurgitation and aortic valve is least affected, therefore, in every case of chronic rheumatic fever mitral valve should be thoroughly examined.