Pattern of valvular lesions in rheumatic heart disease

ABSTRACT

To evaluate relative frequency of cardiac lesions in Rheumatic heart disease [RHD] in patients presenting to cardiology department, Lady Reading Hospital, Peshawar. This retrospective study was conducted at Cardiology Department Lady Reading Hospital Peshawar. The data on patients undergoing transthoracic two-dimensional echo and Doppler studies were retrieved from the computerized database from July 2003 to July 2006. The data was analysed with SPSS 11 window. Out of 3060 patients of RHD [1278 male and 1782 female], 1723 [56.3%] had mixed valvular lesions. Mean age was 22 + 6 years. Mitral stenosis [MS] was the predominant valvular lesion affecting 2141 [70%] patients [1040 pure MS and 1101 in combination]. Of those, 525 [24.5%] patients had severe MS, and 811 [37.9%] had moderate MS. Mitral regurgitation [MR] affected 1793 [58.59%] patients [245 pure MR, 1548 mixed] while 404 [22.5%] patients had severe MR and 497 [27.1%] had moderate MR. Aortic regurgitation [AR] was present in 1438 [47%] patients and almost always [98 85%] in combination. One hundred and eight [7.5%] patients had severe AR. Aortic stenosis [AS] was noted in 48 [1.56%] patients, of which 30 [62.5%] were in isolation and 18 [37.5%] in combination. Out of 1723 mixed lesions, MS+MR+AR were found in 826 [47.94%] cases and MR+AR in 428 [24.84%] cases. Most of the patients had mixed Valvular lesions. The predominant lesion was mitral stenosis followed by mitral regurgitation, aortic regurgitation and aortic stenosis respectively