Why the study?
What is the long-term natural history and diagnostic accuracy of rheumatic heart disease diagnosed during pregnancy?
What is the long-term natural history and diagnostic accuracy of rheumatic heart disease diagnosed during pregnancy?
False diagnosis of rheumatic heart disease during pregnancy is common, emphasizing the need for careful evaluation of cardiac murmurs in pregnant patients.
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May indicate frequent overdiagnosis of RHD in pregnancy; leaves open precise long-term natural history and diagnostic accuracy.
One hundred one patients originally diagnosed as having rheumatic heart disease (RHD) during the years 1945-1948 were reevaluated in 1975 to determine the natural history of the disease. Twenty patients (19.8%) showed no sign of RHD. Of the patients with confirmed RHD, 56 (70.0%) had their original lesion confirmed, while 23 (28.8%) had developed additional valvular involvement. Pure mitral stenosis resulted in significantly lower mortality than all other valvular lesions, and congestive heart failure was the leading cause of death. Nineteen patients underwent cardiac surgery; the mortality in this group (52.6%) was not significantly higher than that in the overall RHD group (38.8%). False diagnosis of RHD during pregnancy is common. A more thorough evaluation of the "cardiac murmur of pregnancy" is advocated.
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Gleicher et al. (1979) studied this question.
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