ORTIC VALVE INVOLVEMENT IN RHEUMATIC HEART DISEASE

Rheumatic heart disease is a common cause of cardiovascular morbidity and mortality in Pakistan especially in its underdeveloped regions like Bahawalpur and its surrounding areas. Rheumatic heart disease (RHD) involves both the mitral and aortic valves with mitral being the predominant. We in our hospital are receiving many patients of rheumatic heart disease presenting with aortic valve involvement. So this observational study was carried out in Bahawal Victoria Hospital Bahawalpur to see the frequency of aortic valve involvement in patients of rheumatic heart disease, and their modes of presentation. Fifty (50) patients admitted to various units of Bahawal Victoria Hospital, Bahawalpur with RHD were collected. The patients who fulfilled the inclusion criteria were included in the study. We noted the relative age and sex distribution and the frequency of involvement of various valves specially the aortic valve. We also noticed the modes of presentation of these patients. Twelve out of 50 patients had aortic valve involvement out of which only 1 had pure aortic valve and other 11 had also mitral valve involvement. Majority of patients of aortic valve disease presented in NYHA class II III. Most of the patients with aortic valve disease were 20-40 years of age while the M: F ratio was 1:1. As a conclusion aortic valve is the second most common valve involved in patient with RHD. It is usually involved with the mitral valve and is rarely involved alone. Most of the patients with aortic valve involvement presented with advanced disability as regards the functional status