• Hamza Arslan Aurakzai
  • Shahid Hameed
  • Ahmad Shahbaz
  • Salman Gohar
  • Moqueet Qureshi
  • Habibullah Khan
  • Waqas Sami
  • Muhammad Azhar
  • Jawad Sajid Khan


Background: Rheumatic Heart Disease (RHD) continues to be a major public health problem indeveloping countries like Pakistan. Objective of this cross sectional-analytical study was to analyzethe severity of valvular lesions on echocardiography in patients pre-diagnosed with RHD. Methods:The transthoracic echocardiographic records of RHD patients from 2004 to 2008 wereretrospectively reviewed for type and degree of valvular involvement according to AHA/ACCguidelines. Results: A total of 13,414 patients [7,219 Males (53.8%), 6,195 Females (46.2%)]ranging from 11 to 90 years with a mean age of 42.33±18.976 were studied. On echocardiography,7,500 (56%) had mitral regurgitation (8.8% severe MR), 6,449(48.2%) had tricuspid regurgitation(7.1% severe TR) and 5,550 (41.4%) had aortic regurgitation (4.8% severe AR). MS was detected in2,729 (20.3%) patients (15.3% severe MS), AS in 102 (0.8%) and TS in 31 (0.2%) patients. Mixedmitral valve disease was seen in 3,185 (23.7%), mixed aortic valve disease in 222 (1.7%) and mixedtricuspid valve disease in 47 (0.4%) patients. All three valves were involved in 2,826 (21.06%)patients, combination of mitral and aortic valves in 3,103 (23.13%), mitral and tricuspid in 3,784(28.2 %), and mitral only in 3,701 (27.59%) patients. There was some mitral valve abnormality in allpatients. Conclusion: Mitral valve was most commonly affected, while regurgitant lesions weremore common than stenotic lesions, and most severe in younger patients. All valvular lesions hadalmost an equal distribution among the sexes, except aortic regurgitation, which was more commonin females. Therefore, echocardiography should be done routinely for patients with RHD, focusingon younger population, to facilitate diagnosis and definitive treatment before complications set in.Keywords: Rheumatic heart disease, Echocardiography, Valvular heart disease


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