FREQUENCY OF SEVERE MITRAL STENOSIS IN YOUNG FEMALE PATIENTS HAVING PURE MITRAL STENOSIS SECONDARY TO RHEUMATIC HEART DISEASE
Abstract
Background: High morbidity and mortality due to Rheumatic heart disease (RHD) associatedwith females is mainly because of late diagnosis on one hand and socioeconomic reasons on theother hand. Poor referral to tertiary care centres leads to delayed diagnosis which results incomplications. The objectives of this cross-sectional descriptive study was to assess the frequencyof severe mitral stenosis in woman of child bearing age, having pure mitral stenosis (MS)secondary to rheumatic heart disease. Methods: Two hundred and fifty women of child bearingage with RHD were enrolled in the study using consecutive non-probability sampling technique.Out of these 250 patients, cases of pure MS were selected. Patients with associated mitralregurgitation and aortic valve disease were excluded. After admission, assessment of mitral valvestenosis was done with 2D colour Doppler echocardiography. Results: Out of 250 consecutivepatients of rheumatic carditis, 110 (44%) patients had pure mitral valve stenosis, 85 (34%) hadstenosis with mitral regurgitation and 55 (22%) patients had both mitral and aortic valve problemof varying severity. Among 110 patients with pure mitral valve stenosis, 48 (43.6%) had severemitral valve stenosis. Severe mitral valve gradient (MVG) and high pulmonary artery pressure(PAP) was observed in 66 (60%) and 49 (44.5%) of the patients respectively. Conclusion: Thishigh frequency can be linked to lack of early detection of the disease at primary level, poormanagement of throat infections and poor rheumatic fever prophylaxis at community level.Keywords: Rheumatic heart disease, mitral stenosis, mitral valve gradient, pulmonary arterypressure, primary health centreReferences
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