Abstract

  RHD is a major complication of Rheumatic fever, affecting children and young adults in there most productive years of life, despite found decreasing in the developed world, it is still a major cause of acquired cardiovascular mortality and morbidity in our country. In this study sample was selected randomly from pediatric and adolescent RHD patients aged upto 18 years if they fulfill the inclusion criteria. All the 102 children were first clinically evaluated as per case record form, then undergone serial relevant investigation. Echocardiography (2D, M-MODE and COLOUR-DOPPLER) was done. Results showed slight male preponderance among the patients, the mean age of patients was 11.43 ± 3.58 years, majority of them 85.29% were from rural areas and belong to low socioeconomic class, history of rheumatic fever in past was present in 38.23% patients. Most common mode of presentation was heart failure seen in 31.37% of patients, a significant proportion of patients had recurrence of rheumatic fever (18.62%), mostly those who were non-compliant to penicillin prophylaxis, pulmonary hypertension was found in 14.7% of patients. Incidence of other complications such as stroke, infective endocarditis, arrhythmia were low as expected in this age group (upto 18 years), due to the temporal delay in development of complications of RHD. Isolated mitral valve involvement specially isolated mitral regurgitation was the commonest pattern of involvement. Most common presenting symptom was dyspnoea present in 86.27% followed by palpitation, fatigue, chest pain, edema. dyspnoea of majority patients was NYHA Class I and II. Of the studied population 62.74% received regular prophylaxis and 37.25% patients had irregular or no prophylaxis. The incidence of heart failure, pulmonary arterial hypertension and recurrence of rheumatic fever was much higher in the latter group.

Keywords: Rheumatic Heart Disease (RHD); Acute Rheumatic Fever; Valvular Heart Disease; Infective Endocarditis (IE); Mitral Regurgitation (MR); Mitral Stenosis (MS)

References

1. World Health Organization. “WHO technical report series no. 923”. Rheumatic Fever and Rheumatic Heart Disease (2004).
2. World Health Organization. Seventy-First World Health Assembly. Provisional agenda item 12.8. Rheumatic fever and rheumatic heart disease. Report by the Director-General (2018).
3. Jai Vigyan. “Mission mode project on community control of RHD. Non-communicable diseases”. Indian Council of Medical Research Annual Reports (2007): 63-64.
4. Community control of rheumatic fever and rheumatic heart disease. Report of ICMR task force study. New Delhi: Indian Council of Medical Research (1994).
5. Patel DC., et al. "Rheumatic fever and rheumatic heart disease in school children of Anand”. The Journal of the Association of Physicians of India12 (1986): 837-839.
6. Avasthi G., et al. "Prevalence survey of rheumatic fever (RF) and rheumatic heart disease (Rhd) in urban and rural school children in Ludhiana". Indian Heart Journal1 (1987): 26.
7. Carapetis Jonathan R., et al. "Acute rheumatic fever”. The Lancet9480 (2005): 155-168.
8. Ozer Sema., et al. "Childhood acute rheumatic fever in Ankara, Turkey”. The Turkish Journal of Pediatrics 2 (2005): 120-124.
9. Arora R. "Clinical profile of rheumatic fever and rheumatic heart disease: a study of 2,500 cases”. Indian Heart Journal6 (1981): 264-269.
10. Khatoon M. "Clinical profile of rheumatic fever in some hospitalised children of Bangladesh”. Bangladesh Medical Research Council Bulletin1 (1985): 33-38.
11. Radwan A and Bajjey M. “Spotlight on Current Clinical Profile of Rheumatic Heart Diseases (RHD) and Rheumatic Fever (RF) in Sohag University Hospital (Upper Egypt)” (2011).
12. Joseph Nitin., et al. "Clinical spectrum of rheumatic fever and rheumatic heart disease: a 10 year experience in an urban area of South India”. North American Journal of Medical Sciences11 (2013): 647.
13. Ravisha MS., et al. "Rheumatic fever and rheumatic heart disease: clinical profile of 550 cases in India”. Archives of Medical Research5 (2003): 382-387.
14. Zhang Wanzhu., et al. “Presenting features of newly diagnosed rheumatic heart disease patients in Mulago Hospital: a pilot study”. Cardiovascular Journal Of Africa2 (2013): 28-33.
15. Melka A. "Rheumatic heart disease in Gondar College of Medial Sciences Teaching Hospital: socio-demographic and clinical profile”. Ethiopian Medical Journal4 (1996): 207-216.
16. Akinwusi Patience Olayinka., et al. "The new face of rheumatic heart disease in South West Nigeria”. International Journal of General Medicine 6 (2013): 375.
17. Ogah Okechukwu S., et al. "Chronic rheumatic heart disease in Abeokuta, Nigeria: Data from the Abeokuta heart disease registry”. Nigerian Journal of Cardiology2 (2014): 98.
18. Bitar FF., et al. "Rheumatic fever in children: a 15-year experience in a developing country”. Pediatric Cardiology 2 (2000): 119-122.
19. Thakur Jarnail S., et al. "Epidemiological survey of rheumatic heart disease among school children in the Shimla Hills of northern India: prevalence and risk factors”. Journal of Epidemiology and Community Health1 (1996): 62-67.

Citation

Citation: Sandip Gupta., et al. "Clinical Spectrum of Rheumatic Heart Disease in Pediatric and Adolescent Patients Attending B.S.M.C.H, Bankura: A Rural Tertiary Medical Center in India". Acta Scientific Paediatrics 3.11 (2020): 30-36.

Copyright

Copyright: © 2020 Sandip Gupta., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.