Prevalence and Predictors of Atrial Fibrillation and its Embolic Complications in Patients with Rheumatic Heart Disease at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Abstract Background: Atrial fibrillation is one of the complications of rheumatic heart disease, with substantial morbidity and mortality. The prevalence and predictors of atrial fibrillation and its thrombo-embolic complications in Ethiopian patients with rheumatic heart disease are unknown. The objective of this study was to determine the prevalence and predictors of atrial fibrillation and its thromboembolic complications. Methods: A retrospective chart review of 500 patients with rheumatic heart disease at the adult cardiology clinic of Tikur Anbessa Specialized Hospital was carried out from 01 January to 31 June 2016. Data were entered into a pre-tested questionnaire and were analyzed using SPSS version 23. Results: Records of 500 patients (72% female) with electrocardiographic recordings and echocardiographic reports were available for analysis. Atrial fibrillation was found in 234 (46.8%) of the patients. Predictors of atrial fibrillation were found to be: age ≥50 years (p=0.01), left atrial size ≥45mm (p=0.01), the presence of mitral stenosis (p<0.01) and the presence of tricuspid regurgitation (p=0.01). Cardioembolic events were reported in 67 (9.2%) patients, and the presence of atrial fibrillation (p=0.02) and sub-therapeutic anticoagulation status (p<0.01) were significant predictors of cardioembolic events. Conclusions and recommendations: The study reveals a high prevalence of atrial fibrillation and cardioembolic events in Ethiopian patients with rheumatic heart disease. Hence, active screening of atrial fibrillation and optimal anticoagulation are recommended

Sudan Rheumatic Heart Disease Control Initiative: achievements and challenges: 2012-2017. Sudan RHD Control Committee

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Echocardiographic Features of Rheumatic Heart Disease in Lagos

Rheumatic heart disease (RHD) is a global scourge; resulting in significant morbidity and mortality. Our aim is to report on the prevalence; and complications of RHD; as documented by echocardiography in a Nigerian tertiary health facility. We performed a retrospective study of RHD patients; who had trans-thoracic echocardiography studies within the 2 year period of January 1st 2001-December 31st 2002. Data obtained included age; sex and echocardiographic diagnoses; and parameters. Of the 987 patients; 53 had chronic RHD; thus; the prevalence was 5.4. Male female ratio was 1: 1.8 and their average age was 30.1 years. Commonest indication for study was congestive heart failure (68). One; two and three valves were affected in 45 (85); 7 (13); and 1 (2) respectively. Valves involved were mitral - 49 (93); aortic - 18.6; and tricuspid 2 (7.5) respectively. Mixed mitral stenosis/regurgitation (42) was the commonest lesion; and complications included right ventricular overload (20); thromboembolic risk (20); and heart failure (70). RHD is still prevalent in Lagos; Nigeria and associated with grave complications. Valvular involvement remains unchanged as the mitral valve still is the most commonly affected valve but there seems to be an increasing prevalence of mixed mitral valve disease thus making management more challenging. Comprehensive hospital registers for rheumatic heart disease and community based studies are needed to establish the current prevalence

Cardites rhumatismales de l'enfant: etude clinique et evolutive a propos de 45 cas

les auteurs etudient 45 cas de cardites rhumatismales colliges entre janvier 1989 et decembre 1992 dans le service de pediatrie du CHU de Brazzaville et repondant aux criteres de Jones revises. La frequence etait de 0;78 pour cent; l'age moyen de 10 ans et 4 mois. Il y avait 26 filles et 19 garcons. L'insuffisance cardiaque presente dans 32 cas; l'index cardiothoracique superieur a 0;60 dans 33 cas temoignent de la gravite de cette affection

Perinatal mortality and maternal mortality and morbidity in rheumatic heart disease

The early onset of rheumatic fever with frequent recurrence and rapid progression to severe and incapacating chronic valcular disease has been repeatedly highlighted in Nigeria. Interestingly; the peak frequency of age distribution of rheumatic heart disease (RHD ) is in the early childbearing age. This prospective study was therefore undertaken to evaluate perinatal mortality and maternal morbidity and mortality in RHD in pregnant Nigerians in the University College Hospital; Ibadan; Nigeria; from January 1972 to December 1979. The clinical course of 44 pregnancies in 32 Nigerian women with RHD was studied. The perinatal and maternal deaths were recorded. While perinatal mortality among patients with RHD was found to be 90.8 per thousand; and maternal mortality 68 per thousand; the overall perinatal mortality was 60.4 per thousand and maternal mortality was 5.31 per thousand. Therefore; RHD in pregnancy appears to have substantially contributed to the high maternal mortality

Community survey for rheumatic heart disease (RHD) in Zaire

The high prevalence rate of 22.9 per 1000 obtained in this survey is consistent with the socioeconomic and political crisis instability. Reliable estimates have been obtained by screening schoolchildren. The data indicate that Zairian boys are susceptible to rheumatic heart disease between the ages of 5 and 12 years; and girls are older at rheumatic heart disease onset (13-16 years). Few cases of rheumatic fever were recognised because of the rarity of major manifestations like cholera; erythema marginatum; and subcutaneous nodules. As in many other reports; the mitral valve is the valve most commonly involved. There is a strong association between birth in rainy season; lower socioeconomic status; and rheumatic heart disease occurrence

Community survey for rheumatic heart disease (RHD) in Zaire

The relationship of streptococcal infection with Rheumatic fever (RF) and Rheumatic Heart Disease (RHD) has been well established (1;2). An attack rate of 3 percent was reported in different surveys (3); and occurred most commonly in the young child. Indeed RHD is the leading form of acquired heart disease in the tropics between the ages of 5 and 15 years