An Epidemiological Analysis of Socioeconomic Risk Factors Among Patients of Rheumatic Heart Disease, Islamabad, Pakistan

Abstract

BACKGROUND: Rheumatic Heart Disease (RHD) is a disease of developing countries where it inflects significant burden dis-proportionality. We investigated the role of socio-economic and environmental risk factors for RHD. METHODS:· This was descriptive cross-sectional conducted at Pakistan Institute of Medical Sciences Islamabad by including the patients coming to cardiology out door patient department through convenient sampling technique. Study was approved from ethical committee of Pakistan institute of Medical Sciences Islamabad and written consent was taken prior to start the interview. RESULTS: In this study, the average age of patient with rheumatic heart disease was 29.4 years, male predominance of patients was observed. 67% of subjects had income below Rs. 20,000. Average BMI of subjects was 22.4±4.04. It was observed that 75.25 % of people lived in houses with an area of less than 5 marla. Average area of house was found to be 5.12±2.8 marla. Overcrowding was noticed in 60.8 % of the subjects. CONCLUSION: There is a high prevalence of RHD and Acute Rheumatic Fever (ARF) in Pakistan. The major findings of this study were that Overcrowding, poor hygienic conditions, low socio-economic status, are major risk factors for RHD. In order to address this alarming situation, platforms like Pakistan Pediatric Cardiac Society and Pakistan Pediatric Association need to be mobilized for health promotion regarding awareness of the disease.

Demographic Profile and Clinical History of Newly Diagnosed Mitral Stenosis Patients

“…Detailed clinical characteristics and manifestation are presented in Table 1. Severity of MS was very severe in 8.8% (11), severe in 74.4% (93), and progressive in remaining 16.8% (21). On TTE left atrial thrombus was seen in 8% (10), left atrial smoke in 9.6% (12), and vegetation were seen in 3.2% (4) of the patients.…”

“…Similarly, various studies reported varying rate of RHD in our population depending on region and social segment under study. [10][11][12] The management recommendations as well as timing of management are mostly dependent on individual risk profile of patient, anatomical factors of mitral valve, functional status of the patients, associated valve pathology, and surgical risk of individual, hence all come to play when deciding management strategy. 13,14 In our study only 19.2% of the patients were managed medically, while remaining patients required either surgical or interventional management.…”

Is 3d Transthoracic Planimetry Still Superior Over 2d Echo in Rheumatic Mitral Stenosis When Both Area and Hemodynamic Parameters of Severity Are in Question?

“…Rheumatic fever is commonly seen in underdeveloped countries and also shows a high prevalence in Pakistan. 1 , There has been a trend in the increase of rheumatic cases in our region especially of mitral stenosis from the past 40 years 2,3 Mitral stenosis has been considered as one of the commonest valvular pathology associated with it and, if not treated timely leads to different complications 4,5 and resultantly high morbidity and mortality. 6 Various treatment options are available including medical management, balloon commissurotomy and finally surgical replacement of the diseased valve with prosthetic one.…”