Key result
Heart failure affects ~89% of hospitalized patients with rheumatic heart disease, predominantly with mitral regurgitation.
Why the study?
Rheumatic heart disease continues unabated among middle-income and low-income countries, prompting this assessment of clinical and echocardiographic characteristics and management practices.
Cross-Sectional (n=47)
No
Rheumatic heart disease predominantly affects younger adults and frequently presents with severe valvular lesions, congestive heart failure, and atrial fibrillation, highlighting the need for routine echocardiographic screening.
Answers are grounded in this paper and cite their sources.
Highlights severe RHD presentations in hospitalized patients; leaves open whether echocardiographic screening improves outcomes in endemic regions.
BACKGROUND: Rheumatic heart disease (RHD) is the long-term consequence of acute rheumatic fever (ARF), continues unabated among middle-income and low-income countries. Thus, this study aimed to assess clinical characteristics, echocardiographic characteristics, and management practice of RHD patients. METHODS: Hospital-based prospective cross-sectional study was used. The data were collected from medical records of consecutive patients admitted to medical wards during the study period. The data were cleaned and analyzed using SPSS version 20. Descriptive statistics were used to describe the data. Chi-square was used to compare proportions between categorical variables. RESULTS: Forty-seven patients with a median (IQR) age of 28.0 (17.0-40.0) years were included. Pan systolic murmur was reported in 91.50% of patients. Forty-two (89.4%) of patients were presented with congestive heart failure and 23 (48.9%) with atrial fibrillation. Mitral valve leaflet thickening and calcification with restriction of motion were reported in 91.5% of patients. Mitral regurgitation (MR) (87.2%) and stenosis (MS) (85.1%) were the most common valvular lesions. The combinations of three (MR+MS+TR) 14 (29.8%) and four (MR+MS+TR+AR) 13 (27.7%) valve diseases were most commonly reported. Diuretics (95.7%), anticoagulants (38.3%), digoxin (36.2%), and beta-blockers (34.0%) were among the commonly prescribed medications. CONCLUSION: Rheumatic heart disease affected younger adults. Pansystolic murmur was reported in nearly all patients. Congestive heart failure and atrial fibrillation were common clinical presentations. Morphologic changes in mitral valve and pathologic mitral regurgitation were the most common echocardiographic reports. Cardiovascular medications were commonly utilized for symptomatic management of complications Therefore, echocardiography should be done routinely for patients with RHD, focusing on younger adults, to facilitate diagnosis and treatment before complications develop.
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Mulugeta et al. (2020) conducted a cross-sectional in Rheumatic valvular heart disease (n=47). Rheumatic heart disease was evaluated on Congestive heart failure presentation. Among hospitalized patients with rheumatic heart disease, 89.4% presented with congestive heart failure, 48.9% had atrial fibrillation, and mitral regurgitation was the most common lesion.
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