PATTERN OF VALVULAR LESIONS IN RHEUMATIC HEART DISEASE

Abstract

Objective: To evaluate relative frequency of cardiac lesions in Rheumatic heart disease (RHD) in patients

presenting to cardiology department, Lady Reading Hospital, Peshawar.

Material and Methods: 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.

Results: 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.

Conclusion: Most of the patients had mixed Valvular lesions. The predominant lesion was mitral stenosis

followed by mitral regurgitation, aortic regurgitation and aortic stenosis respectively.