LEFT ATRIAL ENLARGEMENT IN CHILDREN SCREENED FOR RHEUMATIC HEART DISEASE IN SAMOA

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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Giant Left Atrium in Rheumatic Heart Disease: The Classic Signs of Left Atrial Enlargement

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2012.11.066 ◽

2013 ◽

Vol 44 (6) ◽

pp. e393-e394 ◽

Cited By ~ 5

Author(s):

Jeffrey Forris Beecham Chick ◽

Scott E. Sheehan ◽

Jared D. Miller ◽

Ryan J. Bair ◽

Rachna Madan

Keyword(s):

Heart Disease ◽

Left Atrium ◽

Rheumatic Heart Disease ◽

Left Atrial ◽

Left Atrial Enlargement ◽

Atrial Enlargement ◽

Giant Left Atrium ◽

Rheumatic Heart

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Light and electron microscopic features of surgically excised left atrial appendage in rheumatic heart disease patients with atrial fibrillation and sinus rhythm

Cardiovascular Pathology ◽

10.1016/j.carpath.2014.07.008 ◽

2014 ◽

Vol 23 (6) ◽

pp. 319-326 ◽

Cited By ~ 15

Author(s):

Shruti Sharma ◽

Gautam Sharma ◽

Milind Hote ◽

V Devagourou ◽

Vikas Kesari ◽

...

Keyword(s):

Atrial Fibrillation ◽

Heart Disease ◽

Sinus Rhythm ◽

Rheumatic Heart Disease ◽

Left Atrial ◽

Left Atrial Appendage ◽

Atrial Appendage ◽

Electron Microscopic ◽

Microscopic Features ◽

Rheumatic Heart

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Role of Lymphocyte Subsets in Pathogenesis of Chronic Rheumatic Heart Disease

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849239800600207 ◽

1998 ◽

Vol 6 (2) ◽

pp. 104-107

Author(s):

Rajendar K Suri ◽

Neerod K Jha ◽

Harpreet Vohra ◽

Ratna S Manjari ◽

Rajam Venkateshwaran ◽

...

Keyword(s):

Flow Cytometry ◽

T Cells ◽

Heart Disease ◽

Rheumatic Heart Disease ◽

Left Atrial ◽

Left Atrial Appendage ◽

Lymphocyte Subsets ◽

Cd4 Cells ◽

Activated T Cells ◽

Rheumatic Heart

Analyses of lymphocyte subsets using flow cytometry were conducted to determine the significance of these cells in the pathogenesis of chronic rheumatic heart disease. Lymphocytes (B cells, T cells, CD4 cells, CD8 suppressor or cytotoxic T cells, activated T cells, and natural killer cells) were measured in blood and left atrial appendage samples of 30 patients with rheumatic heart disease and 10 patients with acyanotic congenital heart disease. Monoclonal fluorescent-labeled antibodies were used to identify various cells by flow cytometry. There was a significant increase in CD4 cells and activated T cells with a significant decrease in B cells in the left atrial appendage tissue of patients with rheumatic heart disease compared to those in the control group. There was no significant difference between the two groups in the distribution pattern of T lymphocytes in peripheral blood. These changes in rheumatic heart disease reflect an abnormal immunoregulatory mechanism with an ongoing enhanced immunological process continuing into the chronic phase of the disease. In our opinion, this persistent T cell response may lead to fresh damage to the myocardium and deformation of the heart valves.

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The clinical and etiological profile of atrial fibrillation after echocardiography in a tertiary care centre from North India - a cross sectional observational study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20170623 ◽

2017 ◽

Vol 5 (3) ◽

pp. 847 ◽

Cited By ~ 2

Author(s):

Ranvijay Singh ◽

Rajesh Kashyap ◽

Rajeev Bhardwaj ◽

Rajeev Marwaha ◽

Manish Thakur ◽

...

Keyword(s):

Atrial Fibrillation ◽

Heart Disease ◽

Left Atrial ◽

Left Atrial Appendage ◽

Tertiary Care ◽

Hypertensive Heart Disease ◽

Atrial Appendage ◽

North India ◽

Left Atrial Enlargement ◽

Atrial Enlargement

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice. In western countries, rheumatic heart disease (RHD) is a rare cause of atrial fibrillation but in developing countries like India it is one of the commonest cause of atrial fibrillation. We studied etiology, left atrial size and the incidence of left atrial appendage clot in patients with atrial fibrillation at our institution so that guidelines could be formulated to manage the patients of AF in the hours of emergency.Methods: 110 consecutive patients of atrial fibrillation coming to emergency, cardiology and medicine outpatient department over a period of one year were enrolled for the study. Ethical committee clearance was taken. Detailed history were taken, clinical presentation reviewed and examination were carried out. All patients were subjected to transthoracic echocardiography and for transesophageal echocardiography if required.Results: The mean age of patients in the study was 58.42±14.27 years (range 22-90 years). Maximum numbers of patients were in the age group of 61-70 years (26.37%). Out of 110 patients with atrial fibrillation, 72 patients (65.46%) were females and 38 patients (34.54%) were males. Majority of patients presented with more than one symptom. Out of 110, 66 patients (60%) had RHD. Among RHD patients, 50 patients (45.55%) were females and 16 patients (14.55%) were males. Next common causes were hypertensive heart disease and degenerative valvular heart disease.Conclusions: In our study RHD was the most common cause of atrial fibrillation, followed by hypertensive heart disease and degenerative valvular heart disease. Mitral valve involvement was seen in all patients of RHD. Left atrial enlargement was seen in majority of patients, so left atrial enlargement could be a predictor of atrial fibrillation. Patients of left atrial enlargement are more prone to develop left atrial appendage clot.

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