An echocardiographic study of Rheumatic Heart Disease amongst children in a Tertiary Centre

Abstract

Background: Rheumatic Heart Disease (RHD) is a major form of acquired heart disease amongst children in developing countries, where it continues to be a cause of childhood morbidity and mortality. Objective: To describe the prevalence and spectrum of valvular affectation in children with RHD from the echocardiography laboratory. Methods: The records of echocardiographic scans conducted over a 10-year period in a tertiary health facility were reviewed. Children with RHD, diagnosed using standard criteria were identified. The pattern and severity of valvular involvement and other associated cardiac abnormalities were recorded. Results: Forty-one of the 2742 (1.5%) children who had echocardiography had RHD. Their mean age was 10.9±3.1 years; 28 (68.3%) were aged ≥10 years while 21 (51.2%) were males. Mitral valve was the predominantly affected valve in 40 (97.6%) children and mitral regurgitation was the commonest valvular abnormality in 19 (46.3%) cases. Nineteen (46.3%) had severe valvular damage, 5 (12.2%) had pericardial effusion while 7 (17.1%) died. Only 2 (4.9%) children had valvular repair surgery. Conclusion: Although the prevalence of RHD in this study is low, it is noteworthy that RHD still affects Nigerian children. The poor access to surgery emphasizes the need to strengthen both primary and secondary prevention of RHD while enhancing facilities for surgical intervention.