Acta Scientific Paediatrics (ISSN: 2581-883X)

Research Article Volume 3 Issue 11

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

Sandip Gupta1*, Snehansu Chakraborti2 and Kanak Kr. Mitra3

1Post Graduate Trainee, Department of Pediatrics, B.S.M.C. & H, Bankura, WBUHS, India
2Professor and Head of Department of Pediatrics, B.S.M.C. & H, Bankura, WBUHS, India
3Professor and Head of Department of Cardiology, B.S.M.C. & H, Bankura, WBUHS, India

*Corresponding Author: Sandip Gupta, Post Graduate Trainee, Department of Pediatrics, B.S.M.C. & H, Bankura, WBUHS, India.

Received: September 02, 2020; Published: October 16, 2020

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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)

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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.




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