Rheumatic heart disease in Port Harcourt, Nigeria: clinical, demographic and echocardiographic features

  • MR Akpa
  • S Dodiyi-Manuel
  • Z Agada
  • OJ Odia

Abstract

Background: Rheumatic heart disease is endemic in developing countries especially sub- Saharan Africa. However, there is a growing impression that this disease has been eliminated. Availability of echocardiography with colour flow Doppler facilities has significantly improved diagnosis of cardiac diseases. This study aims at documenting the clinical and echocardiographic pattern of rheumatic heart disease in adult patients in Port Harcourt.
Methods: A one-year (April 2009 to March2010) prospective analysis of the clinical profile and echocardiographic features of all the patients who had echocardiographically confirmed rheumatic valvular heart disease from our cardiac laboratory was undertaken.  Trans-thoracic echocardiography was done using M-mode, two-dimensional, pulsed wave, continuous wave and colour flow Doppler techniques.
Results: Twenty two cases of rheumatic valve disease were identified, thirteen males and nine females (M: F=1. 4:1). The age range was 17years to 68years with a mean age of 41.32 ± 16.14 years. The mean systolic blood pressure was 125.48 ± 26.46mmHg and mean diastolic blood pressure was 73.81± 18.57mmHg. The mitral valve was the most commonly involved valve (95.45%), one patient (4.54%)  had only aortic valve involvement, eight (36.36%) had aortic and mitral valve involvement while thirteen (59.09%) had only mitral valve involvement. Fifteen patients presented in heart failure, three presented with palpitation and four presented with recurrent praecordial chest pain.
Conclusion: Rheumatic heart disease remains prevalent among adult Nigerians in Port Harcourt presenting with heart disease. Males predominate and they present commonly in heart failure.
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