ABSTRACT
Background: Congestive heart failure due to underlying primary myocardial disease idiopathic dilated cardiomyopathy is a major cause of heart failure in our country. Mitral regurgitation of varying severity are a common echocardiography features and annular dilation accompanying dilated LV is the presumed mechanism. Aims and Objective: To find the prevalence and pattern of rheumatic valve lesion in patients with Dilated Cardiomyopathy in view of high prevalence of chronic rheumatic heart disease in our country. Methods: An Echocardiography study and analysis of 1182 patients diagnosed as dilated cardiomyopathy in the age group of 20 to 90 yrs was conducted to ascertain the prevalence and spectrum of valvular lesion of rheumatic origin if any. Results: Total no of 1182 cases of DCM patients were included. Female sex dominated the study group 56 % vrs 46 % male patient. Maximum cases were in the age group of 60-70 yrs (56%) followed by 23 % in the age group of 50 to 60 yrs, Around 56 % of Patient diagnosed as DCM had evidence of underlying RHD with Mitral valve thickness with thick subchordal apparatus and/ or aortic valve involement. Mitral valve involvement was found as high as 79% of cases followed by Aortic valve involvement along with mitral valve involvement (21% cases). Conclusion: Prevalence of evidence of chronic rheumatic heart disease in around 56% in dilated cardiomyopathy is surprise finding in the present study and heightened awareness among the treating physicians about the high prevalence of associated rheumatic heart diseases in dilated cardiomyopathy and requires further evaluation to examine if there is causal relationship between the commonly prevalent disease.
ABSTRACT
Background: Congenital heart disease (CHD) is one of the major causes of mortality and morbidity in the paediatricpopulation particularly in neonates and infants of both the developing and developed countries. Importance of congenital defects is more prominent in infants and delay in recognition may adversely effect survival. Objective: To find the prevalence and pattern of CHD in sick neonates in a tertiary care hospital VSSIMSAR Odisha India catering to economically backward area of our country. Methods: A prospective analysis of case of 8.856 patients (0-1 month) was conducted to ascertain the prevalence and spectrum of CHDs. Results: A total of 232 patients out of 8.856, were found having CHDs measuring a prevalence of 26.2/1000 among sick neonates. About 202 (91.3%) were the acyanotics and 20 (8.6%) were cyanotic heart patients. 4 (1.7%)were complex congenital heart disease Among the acyanotic heart diseases the most frequent lesion seen in 126 (62.7%) followed by ASD alone or in combination was detected in 76 cases (37.6 %) followed by PDA alone or in combination in around 74 cases(36.6%). Combined defects PDA and VSD in 40 cases (20.2 %). Valvular PS was observed in 3% of cases among the cyanotic heart diseases Tetralogy of Fallot was the most frequent cyanotic heart disease seen in 9 cases. Conclusion: Prevalence of congenital heart disease is very high among the sick neonates though figure of 26.2/1000 among the sick neonates could be an over estimation of the actual disease burden in our community because of high prevalence of sick children. The study heightened awareness among the treating physicians about the high prevalence of cardiac diseases in sick neonates and early recognition is essential to reduce the mortality and morbidity associated with these ailments.
ABSTRACT
Background: Rheumatic Heart Disease (RHD) constitutes the most common form of Valvular heart disease in India. Rheumatic valvulitis most commonly affects the mitral valve (70% to 75%) followed by combined mitral and aortic involvement (20% to 25%), with isolated aortic disease being uncommon (5% to 8%). However no data is available regarding pattern of valvular involvement in asymptomatic chronic rheumatic heart disease. Aims & Objective: To study the pattern of valvular involvement in asymptomatic chronic rheumatic heart disease. Methods: Total no 12862 in the age group of 20 yrs to more than 90 yrs referred for perioperative evalution, preemplyoment check up, preinsurance check up annual routine health check up for general health, evaluation of atrial fibriiation ante-natal check up were included in the present studyconducted from April 2005 to January 2018. All were screened by standard routine echocardiography procedure. Results: Out of total no of 12862 persons screened Rheumatic valvular lesion was detected in 2057 persons with max prevalence in age group of 40 to 50 yrs. Mitral valve thickening with mild MR was detected in 42% cases followed by thick mitral valve mild MR mild AR in 14%, thick mitral valve with mild AR in 12%, thick mitral valve with mild MS mild MR mild AR in 8%, thick mitral valve with mod MR mild AR in 8%. Mild MS mild AR in 6% thick aortic valve with mild MR in 6%, moderate AR mild MR in 4% moderate MS mild MR in 4%, mod MS mild MR mild AR in2% severe MR mild AR in 2%. Organic Tricuspid Valve disease was detected in 6% of cases. Conclusion: Routine screening study involving asymptomatic patient evaluated by routine echocardiography revealed high prevalence of regurgitation lesion. Mild to moderate MR along with thick valves is the dominant lesion and stenotic lesion are less prevalent among the asymptomatic persons.