Echocardiographic patterns of juvenile rheumatic heart disease at the Kenyatta National Hospital, Nairobi

East Afr Med J. 2005 Oct;82(10):514-9. doi: 10.4314/eamj.v82i10.9349.

Abstract

Objective: To describe the echocardiographic features of children with rheumatic heart disease seen at the Kenyatta National Hospital.

Design: A retrospective study.

Setting: The Kenyatta National Hospital Heart Unit.

Subjects: Patients aged 20 years and less with echocardiographic diagnosis of rheumatic heart disease.

Results: Two hundred and twenty four echocardiograms were analysed. Seventy six point four of cases were aged between 5 and 15 years, while on 3% were less than five years. The combinations mitral and aortic regurgitation was the most common lesion followed by isolated mitral regurgitation. Isolated aortic regurgitation was as rare as isolated mitral stenosis in the paediatric age group 1.8% and 2.7% respectively. When seen in the younger age group, the leaflet morphology in mitral regurgitation was predominantly thickening and clubbing of the leaflets while in the older children the pathology was of marked fibrosis of the sub-valvular apparatus. Leaflet prolapse and commissural fusion was the major pathology in aortic regurgitation. Pulmonary hypertension was the most common complication commonly seen in mitral valve disease. Calcification was a rare encounter in this age bracket.

Conclusions: Rheumatic heart disease in the paediatric age commonly presents as isolated mitral regurgitation or in combinations of mitral and aortic regurgitation. The complications of pulmonary hypertension was predominant in mitral valve disease. Valvular calcification is rare in juvenile rheumatic heart disease.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aortic Valve Insufficiency / diagnostic imaging*
  • Aortic Valve Insufficiency / epidemiology
  • Cardiology Service, Hospital / statistics & numerical data
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Kenya / epidemiology
  • Male
  • Mitral Valve Insufficiency / diagnostic imaging*
  • Mitral Valve Insufficiency / epidemiology
  • Mitral Valve Stenosis / diagnostic imaging*
  • Mitral Valve Stenosis / epidemiology
  • National Health Programs
  • Retrospective Studies
  • Rheumatic Heart Disease / diagnostic imaging*
  • Rheumatic Heart Disease / epidemiology
  • Ultrasonography