PATTERN OF VALVULAR LESIONS IN RHEUMATIC HEART DISEASE

Objective: To evaluate relative frequency of cardiac lesions in Rheumatic heart disease (RHD) in patients presenting to cardiology department, Lady Reading Hospital, PeshawarMaterial and Methods: This retrospective study was conducted at Cardiology Department Lady Reading Hospital Peshawar The data on patients undergoing transthoracic two-dimensional echo and Doppler studies were retrieved from the computerized database from July 2003 to July 2006. The data was analysed with SPSS 11 windowResults: Out of 3060 patients of RHD (1278 male and 1782 female), 1723 (56.3%) had mixed valvular lesions. Mean age was 22+6 years. Mitral stenosis (MS) was the predominant valvular lesion affecting 2141 (70%) patients (1040 pure MS and 1101 in combination). Of those, 525 (24.5%0) patients had severe MS, and 811 (37.9%) had moderate MS. Mtral regurgitation (MR) affected 1793 (58.59%) patients (245 pure MR, 1548 mixed) while 404 (22.5%) patients had severe MR and 497 (27.1%) had moderate MR.. Aortic regurgitation (AR) was present in 1438 (47%) patients and almost always (98.85%) in combination. One hundred and eight (7.5%0) patients had severe AR. Aortic stenosis (AS) was noted in 48 (1.56%) patients, of which 30 (62.5%) were in isolation and 18 (37.5%) in combination. Out of 1723 mixed lesions, MS+MR+AR were found in 826 (47.94%0) cases and MR+AR in 428 (24.84%0) cases.Conclusion: Most of the patients had mixed Valvular lesions. The predominant lesion was mitral stenosis followed by mitral regurgitation, aortic regurgitation and aortic stenosis respectively.