Abstract
Introduction: Streptococcus pyogenes group A beta-hemolytic produces rheumatic heart disease, a chronic condition. In countries with low and intermediate incomes, it signicantly increases morbidity and mortality. Aims and objectives: To assess the precipitating causes for Frank congestive cardiac failure in patients with established RHD and evaluate the diagnostic problems of fresh rheumatic activity versus infective endocarditis. This was a hospital-based prospective, observational study conducted on Methodology: 150 patients with RHD with cardiac failure admitted to the tertiary care centre in the hospital in the department of general medicine. In patients (≤20 years) Fresh Rheumatic Activity Results: (FRA) was the single most important factor in 85.7%, followed by infection (47.8%) while in patients >20 years, infective endocarditis (92.9%), strenuous physical activity (84.2%) and irregular treatment (72.4%), were a few of the more common factors responsible for precipitation of CCF as compared with patients ≤20 years of age. FRA and infective endocarditis we Conclusion: re the most common precipitating factors in patients ≤20 years and >20 years respectively
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