Echocardiographic Features of Rheumatic Heart Disease in Lagos

ABSTRACT

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