scholarly journals Pattern of rheumatic heart disease in patients admitted at tertiary care centre of Nepal

2018 ◽  
Vol 15 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Prabha Chapagain Koirala ◽  
Ram Kishor Sah ◽  
Deewakar Sharma
Keyword(s):  
Developing Countries ◽  
Heart Disease ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Rheumatic Heart Disease ◽  
Tertiary Care ◽  
Female Ratio ◽  
National Heart ◽  
Number Of Patients ◽  
Rheumatic Heart

Background and Aims: As in other developing countries, Rheumatic Heart Disease (RHD) remains a major public health problem in Nepal. The most commonly affected people are children and adults in their productive years of age. The major contributing factors for high prevalence of Rheumatic Heart Disease in developing countries are poverty, illiteracy and limited access to healthcare services. The study was done to assess the basic pattern of Rheumatic Heart Disease among patients admitted at tertiary care center of Nepal: Shahid Gangalal National Heart Center.Methods: It is a cross sectional prospective study done among the patients admitted in Shahid Gangalal National Heart Center, Kathmandu.Results: RHD was more common among patients of age group 10-40 years, the most common age being 31-40 years (28.5%), with the male female ratio 1:1.6. Majority of the admitted patients had come from Central Development Region, and least number of patients had come from Far Western Region. About 46.5% of patients were illiterate and majority of patients were without any income source. Mitral valve was the most commonly affected valve (98.2%) and mitral regurgitation was the most common valvular lesion.Conclusion: RHD mainly affects children and young people of low socioeconomic group. In our study, mitral valve was the most commonly affected valve and mitral regurgitation was the most common valvular lesion. Mitral Stenosis was  statistically significant in female patients while aortic regurgitation as well as aortic stenosis were significant in male patients.Nepalese Heart Journal 2018; 15(1): 29-33

scholarly journals Prevalence and Involvement of Different Valves in Rheumatic Heart Disease- An Observational Echocardiographic Study in a Tertiary Care Centre, Bengaluru, India

2021 ◽  
Author(s):  
S Lalitha ◽  
Vijay Sai ◽  
Prajith Pasam ◽  
V Bhargavi
Keyword(s):  
Developing Countries ◽  
Heart Disease ◽  
Mitral Valve ◽  
Rheumatic Heart Disease ◽  
Tertiary Care ◽  
Valve Disease ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Study Population ◽  
Rheumatic Heart

Introduction: Rheumatic Heart Disease (RHD) is a non suppurative sequelae of group A beta haemolytic streptococci, resulting from inadequately treated streptococcal sore throat or scarlet fever and leading to valvular heart disease. Rheumatic heart disease is a major cause of morbidity and mortality in younger population in developing countries. The present study was done at a tertiary care medical college hospital with the objective of establishing prevalence and involvement of different valve patterns by Echocardiography (ECHO). Aim: To analyse the valvular pattern of RHD over a period of four years in a tertiary care centre and highlight the importance of ECHO in the definitive diagnosis of RHD, and to know the continuing burden of RHD. Materials and Methods: This was a hospital based retrospective observational study conducted at Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India. A total of 518 cases of RHD were selected as a study population among the ECHO performed between January 2016 and January 2020 after an exclusion criterion of degenerative mitral and aortic valve disease, congenital aortic and mitral valve disease, myxomatous mitral valve disease, trivial and functional regurgitation. Analysis of valvular pattern was performed. Data analysis was done by tables, charts, percentages and ratio. Results: A total of 518 patients were diagnosed to have RHD by 2-Dimensional ECHO. Among them 276 (53%) were females and 242 (47%) were males. The average age was 41.9 years. The most common valve involved independently and in combined lesions was the mitral valve. Of the study population, 446 patients had Mitral Stenosis (MS) and 393 had Mitral Regurgitation (MR). Aortic Stenosis (AS) was found among 111 patients and 304 patients had Aortic Regurgitation (AR). Tricuspid Stenosis (TS) (organic) was found in seven cases. Multiple valves were involved in 204 cases. Among them 104 of the cases had MS, MR and AR, 69 cases had MS, MR, AS and AR, 21 cases had MS, AS and AR, seven cases had MR, AS and AR and three cases had MS, AS, AR and TS. Though aortic valve was involved in multi valvular lesions, significant AR (moderate and severe) was seen in 109 patients and significant AS (moderate and severe) was seen in 67 patients. Conclusion: RHD continues to be a major burden to population in developing countries. In the present study, various patterns of valvular involvement were noted. Drastic measures are to be taken primary and secondary prevention of RHD.

Echocardiographic screening of pregnant women by non-physicians with remote interpretation in primary care

2020 ◽  
Author(s):  
Bruno R Nascimento ◽  
Craig Sable ◽  
Maria Carmo P Nunes ◽  
Kaciane K B Oliveira ◽  
Juliane Franco ◽  
...  
Keyword(s):  
Primary Care ◽  
Heart Disease ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Pregnant Women ◽  
Rheumatic Heart Disease ◽  
Morphological Changes ◽  
Severe Disease ◽  
Left Ventricular ◽  
Rheumatic Heart

Abstract Background Impact of heart disease (HD) on pregnancy is significant. Objective We aimed to evaluate the feasibility of integrating screening echocardiography (echo) into the Brazilian prenatal primary care to assess HD prevalence. Methods Over 13 months, 20 healthcare workers acquired simplified echo protocols, utilizing hand-held machines (GE-VSCAN), in 22 primary care centres. Consecutive pregnant women unaware of HD underwent focused echo, remotely interpreted in USA and Brazil. Major HD was defined as structural valve abnormalities, more than mild valve dysfunction, ventricular systolic dysfunction/hypertrophy, or other major abnormalities. Screen-positive women were referred for standard echo. Results At total, 1 112 women underwent screening. Mean age was 27 ± 8 years, mean gestational age 22 ± 9 weeks. Major HD was found in 100 (9.0%) patients. More than mild mitral regurgitation was observed in 47 (4.2%), tricuspid regurgitation in 11 (1.0%), mild left ventricular dysfunction in 4 (0.4%), left ventricular hypertrophy in 2 (0.2%) and suspected rheumatic heart disease in 36 (3.2%): all, with mitral valve and two with aortic valve (AV) involvement. Other AV disease was observed in 11 (10%). In 56 screen-positive women undergoing standard echo, major HD was confirmed in 45 (80.4%): RHD findings in 12 patients (all with mitral valve and two with AV disease), mitral regurgitation in 40 (14 with morphological changes, 10 suggestive of rheumatic heart disease), other AV disease in two (mild/moderate regurgitation). Conclusions Integration of echo screening into primary prenatal care is feasible in Brazil. However, the low prevalence of severe disease urges further investigations about the effectiveness of the strategy.

scholarly journals Co-existence of ischemic stroke in Rheumatic and non-rheumatic atrial Fibrillation in a tertiary care teaching hospital of Western Nepal

2017 ◽  
Vol 13 (4) ◽  
pp. 388-391
Author(s):  
Ram Chandra Kafle ◽  
Girija Shankar Jha ◽  
Navaraj Paudel ◽  
Vijay Madhav Alurkar
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Rheumatic Heart Disease ◽  
Tertiary Care ◽  
Age Distribution ◽  
Female Ratio ◽  
Common Cause ◽  
Screening Programs ◽  
Rheumatic Heart

Background & Objectives: Stroke is a major public health burden worldwide leading to long-term morbidity and even mortality. Atrial fibrillation (AF) is the most common sustained arrhythmia and is an independent factor to increase risk of ischemic stroke. The risk of stroke further enhanced in rheumatic atrial fibrillation and affects younger population of developing countries.  The study has aimed to find out frequency of co-existence of stroke in AF and secondarily to look for age distribution of stroke and risk factors of AF.Materials & Methods: A retrospective analysis of trans-thoracic echocardiographic records of patients from 1st June 2009 to 31st June 2016 was done. Data were collected in a pre-structured proforma and analyzed.Results: Among 15767 echocardiographies, 577 (3.65%) cases were recorded to have atrial fibrillation. Mean age 65(±15) years ranging from 14 to 100 years. Rheumatic heart disease was the second most common cause of atrial fibrillation after hypertension. The co-existence of ischemic stroke was seen in 87(15.07%) cases with male to female ratio of 1:1.3. The proportion of stroke in rheumatic Atrial fibrillation was 21(18.75%) which was higher than in non-Rheumatic atrial fibrillation 66(14.2%).Conclusion: Rheumatic heart disease is contributing as second most common cause of atrial fibrillation after hypertension, nearly one fourth of total stroke and most common (93%) cause of stroke below the age of 45 years. Preventive strategies aimed at health awareness about rheumatic fever, screening programs at community level, early detection and treatment for hypertension and Rheumatic heart disease can contribute in reduction of stroke burden. 

scholarly journals Strain patterns in primary mitral regurgitation due to rheumatic heart disease and mitral valve prolapse

2020 ◽  
Author(s):  
Gopalan Nair Rajesh ◽  
S.G. Shyam Lakshman ◽  
Haridasdan Vellani ◽  
Chakanalil Govindan Sajeev ◽  
Boban Thomas
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Rheumatic Heart Disease ◽  
Mitral Valve Prolapse ◽  
Primary Mitral Regurgitation ◽  
Rheumatic Heart

scholarly journals Rheumatic fever and rheumatic heart disease: how often we suspect infective endocarditis

2013 ◽  
Vol 34 (3) ◽  
pp. 17-20
Author(s):  
PN Shrestha ◽  
A Das ◽  
A Rayamajhi ◽  
C Mahaseth ◽  
UK Shrestha
Keyword(s):  
Heart Disease ◽  
Infective Endocarditis ◽  
Mitral Regurgitation ◽  
Rheumatic Fever ◽  
Rheumatic Heart Disease ◽  
Major Complication ◽  
Institute Of Medicine ◽  
Female Ratio ◽  
Valvular Lesion ◽  
Rheumatic Heart

Introduction: Rheumatic fever and rheumatic heart disease is a common problem in developing countries. Rheumatic valvular heart disease is one of the important risk factor for infective endocarditis. Methods: Retrospective study was conducted among 56 children admitted in cardiology ward of Kanti children hospital with the diagnosis of rheumatic fever or rheumatic heart disease during May 2008 to May 2010. Results: We found male to female ratio 2: 1, median age 12 (5-14yrs) with the most affected age group of 11-12 years. Common symptoms were fever (66%), dyspnea (68%), joint pain (50%), palpitation (30%), cough (16%) and chest pain (12%). Only 9% of patients had positive history of sore throat. Sixty percent patients were presented with features of congestive cardiac failure (CCF). A SO positive was found in 25 (44.6%) cases. The most common valvular lesion was mitral regurgitation (MR). Moderate to severe mitral regurgitation was found in 89% of cases. Tricuspid regurgitation (T R) was found in 57% of patients and aortic regurgitation (AR) in 55% of cases. Thirty-two patients (57%} had PAH in which 8 patients has severe PAH and 24 patients had mild to moderate PAH. Infective endocarditis was diagnosed in twenty patients (35.7%). Out of 20 patients 14 (70%)had vegetation in echocardiography. The mortality was 11% in this study. Conclusion: Infective endocarditis is the major complication of rheumatic heart disease among children of Nepal and so clinical suspecian is important whenever patients with rheumatic heart disease present with fever. DOI: http://dx.doi.org/10.3126/joim.v34i3.8911 Journal of Institute of Medicine, December, 2012; 34:17-20

INTRAESOPHAGEAL PHONOCARDIOGRAPHY IN THE DIAGNOSIS OF OCCULT RHEUMATIC MITRAL VALVE DISEASE

PEDIATRICS ◽  
1966 ◽  
Vol 38 (5) ◽  
pp. 892-896
Author(s):  
Choompol Vongprateep ◽  
Ronald M. Lauer ◽  
Antoni M. Diehl
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Rheumatic Heart Disease ◽  
Mitral Valve Disease ◽  
Clinical Findings ◽  
Normal Individuals ◽  
Mitral Disease ◽  
Rheumatic Patients ◽  
Rheumatic Heart

Twenty-nine rheumatic subjects and 16 normal individuals have been studied by intraesophageal phonocardiography. In the normal group no unusual sounds or murmurs were discovered by this technique. However, in rheumatic patients with clinical mitral regurgitation the esophageal phonocardiogram more clearly recorded the murmur than the surface phonocardiogram. In five patients murmurs of mitral disease were recorded by the intraesophageal technique that were not discernible by clinical examination or surface phonocardiography. Intraesophageal phonocardiography is particularly valuable in clinical situations wherein rheumatic heart disease is suspected and the typical clinical findings of mitral regurgitation are absent or equivocal.

scholarly journals Pattern of Valvular Involvement in Rheumatic Heart Disease Patients in a Tertiary Care Hospital of Western Nepal

2016 ◽  
Vol 13 (2) ◽  
pp. 29-31 ◽  
Author(s):  
Ram Chandra Kafle ◽  
Vijay Madhab Alurkar ◽  
Navaraj Paudel ◽  
Girija Shankar Jha
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Low Income ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Care Hospital ◽  
Age Group ◽  
Female Ratio ◽  
Rheumatic Heart

Background and Amis: Rheumatic Heart Disease (RHD) is among the commonest diseases of young adults in low-income countries like Nepal. Mitral and aortic valves are more commonly affected than others in RHD. Echocardiography is simple and cost effective tool to identify the patterns of valvular involvement that helps in diagnosis and determines the timing of surgery. This study aimed at determining the pattern of RHD in patients who underwent Echocardiography in a tertiary care hospital of western Nepal.Methods: A retrospective analysis of trans-thoracic echocardiographic record of patients from January 2009 to December 2015 was done. Data were collected in a pre-structured proforma and analyzed.Results: Among 12567 echocardiography, 609 (4.84%) were recorded to have RHD including post valve replacement patients. Females predominated with male to female ratio of 1:2.8. Most patients, 308 (50%) belonged to age group of 21-40 years. The commonest isolated lesion was mitral regurgitation (MR) in 119 (26.21%) patients followed by mitral stenosis (MS) in 31(6.82%) patients. The commonest mixed lesion was MS with MR and aortic regurgitation (AR) seen in 99 (21.8%). The frequency of atrial fibrillation (AF) and stroke was 18% and 3% respectively in RHD patientsConclusions: The proportion of RHD was high in our study. Majority of RHD patients were females of reproductive age group. The commonest lesion was MR followed by mixed valvular lesions.Nepalese Heart Journal 2016; 13(2): 29-31

scholarly journals Pattern of Valvular Involvement in Rheumatic Heart Disease (RHD) Patients attending Referral Cardiac Center in Nepal

2004 ◽  
Vol 3 (3) ◽  
pp. 47-48
Author(s):  
MB KC ◽  
S Kansakar ◽  
YKD Bhatta ◽  
Rajib Rajbhandari ◽  
A Maskey ◽  
...  
Keyword(s):  
Developing Countries ◽  
Heart Disease ◽  
Retrospective Study ◽  
Rheumatic Heart Disease ◽  
Rural Areas ◽  
National Heart ◽  
Cardiac Center ◽  
Rheumatic Heart

Rheumatic heart disease (RHD) is very common in developing countries. It is one of the commonest cardiac problems in Nepal. It is more common in rural areas than in the cities. We performed a retrospective study of RHD patients attending and undergoing echocardiography in Shahid Gangalal National Heart Centre (SGNHC) from January 2002 to December 2002. There were a total of 1843 RHD patients among which 787 (42.8%) were males and 1056 (57.2%) were females.

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