One year echocardiographic study of rheumatic heart disease at Enugu, Nigeria
I O Essien1, B J C Onwubere, B C Anisiuba
1Department of Medicine, University of Uyo Teaching Hospital, Uyo.
Insights
Rheumatic heart disease in Nigeria predominantly affects the mitral valve. Echocardiography is crucial for diagnosing and managing this condition, especially in symptomatic patients.
Area of Science:
- Cardiology
- Echocardiography
- Valvular Heart Disease
Background:
- Rheumatic heart disease (RHD) is a significant cause of cardiac morbidity in Nigeria.
- Prior RHD research in Nigeria relied on clinical or retrospective echocardiographic data.
- This study aimed to assess the burden and characteristics of chronic rheumatic mitral valve disease in Nigeria.
Purpose of the Study:
- To determine the prevalence and patterns of chronic rheumatic mitral valve disease.
- To evaluate the severity and associated valvular lesions in RHD patients.
- To utilize echocardiography for comprehensive assessment of RHD.
Main Methods:
- Prospective study of 55 symptomatic RHD patients from May 2004 to April 2005.
- Utilized M-mode, 2D, pulsed wave, continuous wave, and color flow Doppler echocardiography.
- Assessed mitral and other intracardiac valves for rheumatic heart disease manifestations.
Main Results:
- Mitral valve disease was present in 98.2% of patients; isolated aortic valve disease in 1.8%.
- Mitral regurgitation (64.8%), mixed mitral valve disease (25.9%), and pure mitral stenosis (9.3%) were observed.
- Associated valve conditions included aortic valve disease (33.3%), tricuspid valve disease (24.1%), and pulmonary incompetence (9.3%).
Conclusions:
- Rheumatic heart disease in Nigeria primarily involves the mitral valve, consistent with global patterns.
- Routine echocardiography is recommended for accurate diagnosis and treatment planning in RHD patients.
- Echocardiography facilitates definitive management strategies for rheumatic mitral valve disease.
Background:
Rheumatic heart disease is one of the commonest causes of heart disease in Nigeria. Previous studies on rheumatic heart disease in Nigeria were either clinical or retrospective echocardiographic studies. This study was aimed at determining the burden of chronic rheumatic mitral valve disease, pattern of valvular involvement, severity and associated valvular lesions, using echocardiography.
Patients And Methods:
Between May, 2004 and April 2005, patients with symptomatic rheumatic heart disease, seen in the cardiac clinics of University of Nigeria Teaching Hospital, Enugu, were recruited for the study. The patients were investigated non-invasively with M-mode, Two-dimensional, Pulsed wave, Continuous wave and colour flow Doppler echocardiographic techniques in order to assess the mitral and other intracardiac valves for evidence of rheumatic heart disease.
Results:
There were a total of 55 patients, 39 (70.9%) females and 16 (29.1%) males with a mean age of 29.34 +/- 11.57 years. Mitral valve disease was found in 54 (98.2%) and isolated aortic valve disease in 1 (1.8%) of cases. Mitral regurgitation occurred in 64.8%, mixed mitral valve disease in 25.9% and pure mitral stenosis in 9.3%. Mitral valve disease was associated with aortic valve disease in 33.3%, with tricuspid valve disease in 24.1% and with functional pulmonary incompetence in 9.3% of cases.
Conclusion:
Rheumatic heart disease in Nigeria is essentially a disease of the mitral valve as seen elsewhere in the world. Echocardiography should be done routinely for patients with rheumatic heart disease to facilitate accurate diagnosis and definitive treatment.
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