Frequency & Pattern of Various Valvular Lesions Among Patients with Rheumatic Heart Disease Based on Echocardiographic Records at LRH Hospital Peshawar Pakistan

Abstract

Background: Rheumatic heart disease (RHD) remains a major cause of valvular heart disease in low- and middle-income countries, where recurrent rheumatic fever leads to permanent valvular damage. Understanding the pattern of valvular involvement is essential for early diagnosis and appropriate management.

Objective: To determine the frequency and pattern of various valvular lesions among patients with rheumatic heart disease based on echocardiographic records at Lady Reading Hospital, Peshawar.

Methods: A descriptive cross-sectional, record-based study was conducted on 85 patients with echocardiographically confirmed rheumatic heart disease. Demographic and echocardiographic data were collected and analyzed using Microsoft Excel 2020. Categorical variables were expressed as frequencies and percentages, while age was presented as mean ± standard deviation.

Results: The mean age of the patients was 36.31 ± 8.98 years (range: 17–52 years). Females constituted 56.5% of the study population, and the majority of patients were aged 26–35 years (35.3%). Mitral stenosis was the most common valvular lesion (90.6%), followed by mitral regurgitation (85.9%), tricuspid regurgitation (54.1%), aortic regurgitation (52.9%), and aortic stenosis (34.1%). Mixed valvular lesions were observed in 96.5% of patients, whereas isolated valve involvement was present in only 3.5%. Severe mitral stenosis was identified in 52.9% of cases, moderate mitral regurgitation in 54.1%, mild aortic regurgitation in 37.6%, and mild tricuspid regurgitation in 41.2%.

Conclusion: Rheumatic heart disease predominantly affected young and middle-aged adults, with a higher prevalence among females. Mitral valve involvement, particularly mitral stenosis, was the most common echocardiographic finding, and mixed valvular disease was present in the majority of patients. Early echocardiographic evaluation and timely management are essential to reduce disease progression and improve clinical outcomes