Patterns of Valvular Involvement in Rheumatic Heart Disease patients taking Benzathine Penicillin at Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Background and Aims: Acute rheumatic fever and rheumatic heart disease constitute an important public health problem in the developing countries. The disease results from an abnormal autoimmune response to a group A streptococcal infection in a susceptible host. We aim to describe the pattern of valvular involvement in patients taking Injection Benzathine Penicillin.Methods: All the patients, who were taking injection Benzathine penicillin during 15th April to 14th July, 2013 at our Centre, were included in this study. Demographic features like age, sex, echocardiographic diagnosis along with any adverse effects of Benzathine penicillin were collected.Results: A total of 661 patients were included in our study, out of which female predominated in numbers. Rheumatic heart disease rather than rheumatic fever was the cause for Penicillin injection. Mitral valve was the most common valve involved and it was more common in female.Pure mitral stenosis was the most common valvular involvement. Forty two percent patients underwent intervention; among them Percutaneous transluminal mitral commisuorotomy was the most common. There was no adverse event during the study time following penicillin injection.Conclusions: Women are more commonly affected than male. Mitral valve is the most common valve involved. Nepalese Heart Journal 2016; 13(2): 25-27

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PERUBAHAN MORFOLOGI KATUP MITRAL PADA DEMAM REMATIK AKUT DAN PENYAKIT JANTUNG REMATIK

Human Care Journal ◽

10.32883/hcj.v5i2.779 ◽

2020 ◽

Vol 5 (2) ◽

pp. 455

Author(s):

Dede Jumatri Tito ◽

Mefri Yanni

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Rheumatic Fever ◽

Rheumatic Heart Disease ◽

Cardiac Involvement ◽

Mitral Valve Stenosis ◽

Chordae Tendineae ◽

Industrial Countries ◽

Heart Damage ◽

Rheumatic Heart

<p><em>Rheumatic fever and rheumatic heart disease remains a significant cause of cardiovascular disease in the world, especially in industrial countries and developing countries. Rheumatic heart disease is the most serious complication of rheumatic fever which is characterized by the occurrence of heart valve defects are most of the mitral valve, aortic and tricuspid followed. Valvulitis or inflammatory process in the tissue of the mitral valve causing edema of the valve leaflets and chordae tendineae, causing disruption valve closure is causing mitral regurgitation. Eventually fibrosis and calcification of the valve that causes stiffness and the valve leaflets into mitral valve stenosis. The earliest possible introduction of cardiac involvement in rheumatic heart disease is an important part in the prevention of further heart damage. </em></p>

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Penicillin and Acute Rheumatic Fever

PEDIATRICS ◽

10.1542/peds.70.3.506 ◽

1982 ◽

Vol 70 (3) ◽

pp. 506-507

Author(s):

Bernard Boxerbaum

Keyword(s):

Heart Disease ◽

Mitral Regurgitation ◽

Rheumatic Fever ◽

Rheumatic Heart Disease ◽

Acute Rheumatic Fever ◽

Secondary Prophylaxis ◽

Benzathine Penicillin ◽

Childrens Hospital ◽

Rheumatic Heart

Introduction of secondary prophylaxis for patients with rheumatic fever is felt to be a major reason for improved prognosis of rheumatic heart disease.1,2(p163) The article by Ginsburg et al,3 raising questions concerning the efficacy of this practice, has prompted me to report our experience in the Rainbow Rheumatic Fever Clinic, Rainbow Babies and Childrens Hospital, where more than 80% of the patients receive 1,200,000 units of benzathine penicillin intramuscularly every 28 days. Seventy percent of the patients with rheumatic mitral regurgitation have lost their murmur, and no patient receiving regular intramuscular prophylaxis has developed stenosis.4

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ADHERENCE TO BENZATHINE PENICILLIN IN CHILDREN WITH RHEUMATIC FEVER/ RHEUMATIC HEART DISEASE: RESULTS FROM AN INDIAN PEDIATRIC RHD REGISTRY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(15)62019-8 ◽

2015 ◽

Vol 65 (10) ◽

pp. A2019 ◽

Cited By ~ 5

Author(s):

Anita Saxena ◽

Anurag Mehta ◽

Sivasubramanian Ramakrishnan

Keyword(s):

Heart Disease ◽

Rheumatic Fever ◽

Rheumatic Heart Disease ◽

Indian Pediatric ◽

Benzathine Penicillin ◽

Rheumatic Heart

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Epidemiology and global burden of rheumatic heart disease

ESC CardioMed ◽

10.1093/med/9780198784906.003.0065 ◽

2018 ◽

pp. 314-322

Author(s):

Dianne Sika-Paotonu ◽

Andrea Beaton ◽

Jonathan Carapetis

Keyword(s):

Heart Disease ◽

Rheumatic Fever ◽

Rheumatic Heart Disease ◽

Acute Rheumatic Fever ◽

Indigenous Populations ◽

Autoimmune Response ◽

Global Burden ◽

Streptococcal Infections ◽

Group A ◽

Rheumatic Heart

Acute rheumatic fever is caused by the body’s autoimmune response to a group A streptococcal infection, classically pharyngitis. Rheumatic heart disease refers to the long-term cardiac damage caused by either a single severe episode or multiple recurrent episodes of acute rheumatic fever. It is rheumatic heart disease that remains a significant worldwide cause of morbidity and mortality, particularly in resource-poor settings. Improved living conditions and widespread treatment of superficial group A streptococcal infections have meant acute rheumatic fever/rheumatic heart disease are now rare in developed countries although some Indigenous populations living in wealthy nations are adversely affected. Acute rheumatic fever largely affects children between the ages of 5–14 years with risk factors for acute rheumatic fever/rheumatic heart disease including age, sex, environmental influences that increase exposure to group A streptococcal infections, and host susceptibility. Since rheumatic heart disease results from cumulative damage, the peak prevalence of clinically symptomatic rheumatic heart disease occurs between the ages of 20–40 years. Conservative estimates indicate between 275,000 and 345,000 deaths occur each year from rheumatic heart disease with global burden of disease figures in 2013 calculating at least 32.9 million prevalent rheumatic heart disease cases. In 2015, rheumatic heart disease was ranked as the 43rd leading cause of years of life lost and is attributed to an annual 1.8 million years lived with disability and 9 million lost disability-adjusted life years. More than 75% of the world’s children are currently living in countries where rheumatic heart disease remains endemic. Effective rheumatic heart disease prevention, control, and management warrants prioritization if World Health Organization global targets to reduce premature deaths from cardiovascular diseases by 25% by 2025 are to be achieved.

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ACCESS TO ESSENTIAL MEDICINES: ILLUMINATING DISPARITIES IN THE GLOBAL SUPPLY OF BENZATHINE PENICILLIN G IN THE CONTEXT OF RHEUMATIC FEVER/RHEUMATIC HEART DISEASE PREVENTION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(13)62004-5 ◽

2013 ◽

Vol 61 (10) ◽

pp. E2004 ◽

Cited By ~ 6

Author(s):

Kathryn Taubert ◽

Stephen B. Marko

Keyword(s):

Heart Disease ◽

Disease Prevention ◽

Rheumatic Fever ◽

Rheumatic Heart Disease ◽

Essential Medicines ◽

Penicillin G ◽

Benzathine Penicillin ◽

Benzathine Penicillin G ◽

Access To Essential Medicines ◽

Rheumatic Heart

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

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20193940 ◽

2019 ◽

Vol 7 (9) ◽

pp. 3522

Author(s):

Rohit Mathur ◽

Palsingh Yadav ◽

Sanjeev Sanghvi ◽

Anil Baroopal ◽

Swati Mahajan

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Rheumatic Fever ◽

Rheumatic Heart Disease ◽

Heart Valve Disease ◽

Single Centre ◽

Medical College ◽

Echocardiographic Study ◽

Single Centre Experience ◽

Rheumatic Heart

Background: Rheumatic heart disease (RHD) is a common form of heart valve disease associated with episodes of rheumatic fever. Despite the developments achieved in the field of cardiology, the consequences of acute rheumatic fever remain significantly high in developing countries like India. Objectives of current study aims to evaluate the pattern of valvular involvement in patients of RHD in Western Rajasthan assessed by echocardiography.Methods: This is an observational study conducted at the department of Cardiology, Dr. S. N. Medical College, Jodhpur, India between September 2015 and February 2019. The study includes analysis of echocardiograms of RHD patients performed during this period.Results: Total 502 echocardiograms of RHD patients between 4 and 75 years of age with mean age of 35.6 ±11.6 years in which the most common age group was 21-40 years. There were 191 (38.04%) males, and 311 (61.95%) females. Mitral valve was most commonly involved in which mitral stenosis (MS) was seen in 345 (68.72%) and mitral regurgitation (MR) was seen in 350(69.72%) patients. Aortic stenosis (AS) was seen in 61 (12.15%) and aortic regurgitation (AR) was found in 224 (44.62%) cases. Organic tricuspid valve (TV) disease was seen in 18 (3.58%). In combined valvular involvement MS+MR was seen in 234 (46.61%) cases; followed by MR+AR in 171 (34.06%); MS+AR in 161 (32.07%); AS+AR in 62 (12.35%); MR+AS in 46 (9.16%) and MS+AS in 42 (8.36%) subjects.Conclusion: The echocardiographic pattern of RHD patients of Western Rajasthan shows a predominant involvement of mitral valve, followed by aortic and tricuspid valves. Further amongst multi-valvular involvement the sequence was predominantly MS+MR followed by MR+AR, MS+AR, AS+AR, MR+AS, and MS+AS.

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