Clinical and echocardiographic profile of rheumatic mitral stenosis in a rural based population survey

ABSTRACT

Mitral stenosis [MS] is the leading cause of morbidity and mortality among rheumatic valvular heart disease. Its incidence and clinical pattern has been described in hospital/school based data. We present the full spectrum of rheumatic MS in rural population sample of all ages and various ethnic groups from southern Punjab, Rahim Yar Khan. Study was conducted in 11 villages, randomly selected using scientific sampling technique for prevalence and pattern of RHD. Among 54 cases with RHD more than half were suffering from MS [total 30, isolated 13, and mixed 17] giving an overall prevalence of 3.15/1000. Females had significant preponderance over males. Juvenile MS occurred in 25 percent. Dyspnoea was the commonest symptom. Among abnormal ECG's, 25 percent had AF, 48 percent LAE, 25 percent RVH. Echo/Doppler studies revealed mild MS [53 percent], moderate 30 percent and severe 17 percent. Subvalvular disease and calcification in 16 percent, thrombus 3 percent and vegetation in 2 percent. This study concludes MS being the commonest rheumatic valvular disease, affecting majority of female patients in milder/asymptomatic form that can only be detected through cross-sectional survey