Abstract
Rheumatic heart disease (RHD) is the most common cause of acquired heart disease in children and young adults worldwide and particularly developing countries continuing to experience a high incidence of this disease. The unexpected increase in the incidence of the disease in certain areas may explain the clinical and epidemiological characteristics of this disease. The key manifestation of RHD is the cardiac valvular abnormalities characterized principally by deforming the layered and avascular leaflet architecture due to inflammation and subsequent diffuse fibrosis. Mitral valve is mostly involved and pulmonary valve is rarely affected. Background of these case reports highlighted the increased incidence of rheumatic pulmonary valve disease in Thoothukudi region of India in Tamil Nadu state.
Highlights
Rheumatic fever is the commonest form of heart disease in many developing countries of tropics and subtropics including Southern states of India
The information on the incidence of rheumatic fever and rheumatic heart disease (RHD) mortality is unsatisfactory because the reliable incidence data are very difficult to obtain [2] and hospital statistics give a biased picture of occurrence, since admissions depend on a host of different factors
Endocarditis is manifested as valvular insufficiency and severe scarring of the valve develops during a period of months to years after an episode of acute rheumatic fever, and recurrent episodes may cause progressive damage to the valves
Summary
Rheumatic fever is the commonest form of heart disease in many developing countries of tropics and subtropics including Southern states of India. Rheumatic heart disease prevalence rates are as high as 22 per thousand [4] and even 33 per thousand have been reported in school-age children in urban slums of some developing countries. Retrospective studies in developing countries showed the highest predilection for cardiac involvement and highest recurrence rate of rheumatic fever [7]. Endocarditis is manifested as valvular insufficiency and severe scarring of the valve develops during a period of months to years after an episode of acute rheumatic fever, and recurrent episodes may cause progressive damage to the valves. An isolated rheumatic involvement of pulmonary valve is uncommon in literature and so it had been reported
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