ABSTRACT
Objective: To study the different patterns of valvular malfunction in Rheumatic heart disease (RHD) and assess the factors contributing towards it. Methods: This is an observational study among patients with chronic RHD. One hundred patients (female 81 and 19 males) within ages 12 to 40 years (Mean age 27.3) were analyzed. A relevant clinical history including that of an initial episode of acute rheumatic fever (ARF) and recurrent episodes was obtained. 2D echo assessment of the cardiac valves was performed with an estimation of Wilkins score for the mitral valve (MV). Results: Among the study population female: male ratio was 4:1. 30% had recurrent episodes of ARF. Only 60% had at least some evidence of ARF at any time in their life. The posterior mitral valve appears to be affected more than the anterior leaflet giving an average Wilkins score of 9.7 and 6.7 respectively. The total score had a positive correlation with Mitral stenosis (MS) (p <0.05). MV involvement was noted in 97%. 44% had significant mitral valve prolapse (MVP) but no statistical correlation was noted with mitral regurgitation (MR) (p>0.05). A regurgitant grade of 2 or more was found in 41%. High sensitive C reactive protein of more than 1mg/dl was noted in 55% of patients. Conclusion: Chronic rheumatic MV disease can exist as MS, MR, MVP or simply an elevated valve score. Apart from recurrent streptococcal infections and chronic sub clinical inflammation, a number of different components of valve damage contribute towards the end result.
Subject(s)
Heart Valve Diseases/etiology , Mitral Valve Insufficiency/etiology , Mitral Valve Prolapse/etiology , Rheumatic Heart Disease/physiopathology , Adolescent , Adult , C-Reactive Protein/analysis , Child , Chronic Disease , Echocardiography , Female , Humans , Male , Mitral Valve/physiopathology , Rheumatic Heart Disease/complications , Young AdultABSTRACT
OBJECTIVE: To perform a comparative analysis of in-hospital results obtained from patients with acute ST elevation myocardial infarction (STEMI), who underwent rescue or primary percutaneous coronary intervention (PCI). The aim is to determine rescue PCI as a practical option for patients with no immediate access to primary PCI. METHODS: From the Cardiology PCI Clinic of the National Hospital of Sri Lanka (NHSL), we selected all consecutive patients presenting with acute STEMI
