Prevelance of Rheumatic Valvular Lesion in Dilated Cardiomyopathy: A Study of 1182 Cases of Idiopathic Dilated Cardiomyopathy in a Tertiary Care Hospital

Abstract

Background: Congestive heart failure due to underlying primary myocardial disease idiopathic dilated cardiomyopathy is a major cause of heart failure in our country. Mitral regurgitation of varying severity are a common echocardiography features and annular dilation accompanying dilated LV is the presumed mechanism. Aims and Objective: To find the prevalence and pattern of rheumatic valve lesion in patients with Dilated Cardiomyopathy in view of high prevalence of chronic rheumatic heart disease in our country. Methods: An Echocardiography study and analysis of 1182 patients diagnosed as dilated cardiomyopathy in the age group of 20 to 90 yrs was conducted to ascertain the prevalence and spectrum of valvular lesion of rheumatic origin if any. Results: Total no of 1182 cases of DCM patients were included. Female sex dominated the study group 56 % vrs 46 % male patient. Maximum cases were in the age group of 60-70 yrs (56%) followed by 23 % in the age group of 50 to 60 yrs, Around 56 % of Patient diagnosed as DCM had evidence of underlying RHD with Mitral valve thickness with thick subchordal apparatus and/ or aortic valve involement. Mitral valve involvement was found as high as 79% of cases followed by Aortic valve involvement along with mitral valve involvement (21% cases). Conclusion: Prevalence of evidence of chronic rheumatic heart disease in around 56% in dilated cardiomyopathy is surprise finding in the present study and heightened awareness among the treating physicians about the high prevalence of associated rheumatic heart diseases in dilated cardiomyopathy and requires further evaluation to examine if there is causal relationship between the commonly prevalent disease.