Publication: Rheumatic fever and rheumatic heart disease: how often we suspect infective endocarditis
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Date
2012
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Journal ISSN
Volume Title
Publisher
Institute of Medicine
Abstract
Abstract
Introduction: Rheumatic fever and rheumatic heart disease is a common problem in developing countries. Rheumatic valvular heart disease is one of the important risk factor for infective endocarditis.
Methods: Retrospective study was conducted among 56 children admitted in cardiology ward of Kanti children hospital with the diagnosis of rheumatic fever or rheumatic heart disease during May 2008 to M ay 2010.
Results: We found male to female ratio 2: 1, median age 12 (5- 14yrs) with the most affected age group of 11- 12 years. Common symptoms were fever (66%), dyspnea (68%), joint pain (50%), palpitation (30%), cough (16%) and chest pain (12%). Only 9% of patients had positive history of sore throat. Six ty percent patients were presented with features of congestive cardiac failure (CCF). A SO positive was found in 25 (44.6%) cases. The most common valvular lesion was mitral regurgitation (M R). Moderate to severe mitral regurgitation was found in 89% of cases. Tricuspid regurgitation (T R) was found in 57% of patients and aortic regurgitation (A R) in 55% of cases. Thirty-two patients (57%} had PA H in which 8 patients has severe PAH and 24 patients had mild to moderate PAH . Infective endocarditis was diagnosed in twenty patients (35.7%). Out of 20 patients 14 (70%) had vegetation in echocardiography. The mortality was 11% in this study.
Conclusion: Infective endocarditis is the major complication of rheumatic heart disease among children of Nepal and so clinical suspecian is important whenever patients with rheumatic heart disease present with fever.
Keywords: dyspnea, endocarditis, rheumatic fever, rheumtic heart disease
Description
P N Shrestha
Kanti children hospital, Maharajgunj, Kathmandu, Nepal
A Das
Kanti children hospital, Maharajgunj, Kathmandu, Nepal
A. Rayamajhi
Kanti children hospital, Maharajgunj, Kathmandu, Nepal
C Mahaseth
Kanti children hospital, Maharajgunj, Kathmandu, Nepal
Keywords
dyspnea, endocarditis, rheumatic fever, rheumtic heart disease