Clinical Profle and Management in Children with Rheumatic Heart Disease in a Tertiary Cardiac Care Center of Nepal
Journal Title: Nepalese Heart Journal - Year 2016, Vol 13, Issue 2
Abstract
Backgrounds and Aims: Rheumatic heart disease is the commonest acquired heart disease in children of developing world presenting earlier and with a more severe valvular lesion. This study was conducted to assess the clinical and demographic profle, pattern of valvular involvement and management modalities among children with rheumatic heart disease. Methods: This was a hospital-based observational study, performed at Shahid Gangalal National Heart Center where all children less than 15 years of age with confrmed echocardiographic diagnosis of rheumatic heart disease from June 2015 to May 2016 were evaluated and relevant data were recorded. Results: Two hundred and eleven children were diagnosed with rheumatic heart disease. The mean age was 11.9 ± 2.2 years with (100) 47.4% male and (111) 52.6% female. The median duration of symptoms among new cases was 1 year (interquartile range of 0.5 to 2 years). The most common symptom was dyspnea present in (187) 88.6% children followed by palpitation (34.5%). Mitral valve was most commonly affected in (141) 96.5% while isolated aortic valve involvement was seen in (8) 3.5%. Isolated mitral regurgitation was the most common lesion present in 118 (55.9%) children, while 50 (23.7%) children had combination of mitral and aortic regurgitation. Mitral valve was signifcantly more commonly affected in females and aortic valve commonly affected in males (p= 0.003). Conclusions: Rheumatic heart disease although declining in developed countries, remains to be the commonest acquired heart disease in developing and underdeveloped countries. Efforts are needed to improve primary and secondary preventive measures.
Authors and Affiliations
Poonam Sharma| Department of Pediatric Cardiology, Shahid Gangalal National Heart Center, Bansbari, Nepal Corresponding Author Poonam Sharma, Department of Pediatric Cardiology, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal, Urmila Shakya| Department of Pediatric Cardiology, Shahid Gangalal National Heart Center, Bansbari, Nepal Corresponding Author Poonam Sharma, Department of Pediatric Cardiology, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal, Sunita K. C. | Department of Pediatric Cardiology, Shahid Gangalal National Heart Center, Bansbari, Nepal Corresponding Author Poonam Sharma, Department of Pediatric Cardiology, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal, Manish Shrestha| Department of Pediatric Cardiology, Shahid Gangalal National Heart Center, Bansbari, Nepal Corresponding Author Poonam Sharma, Department of Pediatric Cardiology, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
Takayasu’s Arteritis
Takayasu’s arteritis is a disease of unknown etiology primarily affecting women aged less than 40 years. It is mainly seen in Asians and Africans. This condition is an aorto-arteritis and involves aorta and its major...
Knowledge Regarding Modifable Risk Factors of Coronary Atherosclerosis Heart Diseases in Kathmandu Municipality
Background Progressive urbanizaton and adopton of the “western†lifestyle contributes to the rising burden of cardiovascular disease in the developing world Coronary Atherosclerotc Heart Disease is no longer confne...
ulmonary Embolism presenting as Syncope
The diagnosis of Pulmonary embolism can easily be missed if it is not considered as one of the major differential diagnosis in a case of syncope without chest pain. We describe a case of a 74years old female with pulmona...
CD36 in atherosclerosis
CD36 was described nearly 30 years ago as “glycoprotein IV†the fourth major band of 88KD observed on SDS-PAGE of platelet membrane (1). It is present on many mammalian cell types: microvascular endothelium; professi...
Safety and Diagnostic Accuracy of Dobutamine Stress Echocardiography
Exercise and pharmacologic stress echocardiography has been used routinely in clinical practice for the past twenty to thirty years. Dobutamine stress echocardiography (DSE) is well established as a safe, feasible, and...