RHEUMATIC HEART-DISEASE IN GONDAR-COLLEGE-OF-MEDIAL-SCIENCES TEACHINGHOSPITAL - SOCIODEMOGRAPHIC AND CLINICAL PROFILE

One hundred fourteen patients with rheumatic heart disease were seen b etween January 1994 and January 1995 at Gondar College of Medical Scie nces Teaching Hospital. These patients were prospectively described us ing a prepared study protocol consisting of socio-demographic variable s, clinical findings and laboratory tests. The mean and median age of the patients were 23 +/- 8 years and 22 years, respectively, (range = 5-50 years). About 66% of the patients were females with female to mal e ratio of 1.9:1. Eighty five cases (74.6%) were on follow up with mea n and median duration of 4.32 +/- 4.5 years and 3 years, respectively (range = 1-20 years). The rest (25.4%) of the patients were new. Histo ry findings suggestive of rheumatic fever were obtained in 26% of the patients. Six patients (5.3%) had siblings with similar illness. Frequ ently encountered valve lesions were combined mitral regurgitation and stenosis seen in 29 (25.4%), followed by pure mitral stenosis in 25 ( 21.9%) and mitral regurgitation in 21 (18.4%). The commonest arrhythmi a was atrial fibrillation, observed in 22.8% of the cases. Recurrence of rheumatic fever occurred in 11 patients (9.6%) over the study perio d. Of these, five were regularly taking a four weekly Banzanthine peni cillin injections. The functional classes of patients according to the New York Heart Association's; classification were 17%, 25%, 26% and 3 2% for classes I, II, III and IV, respectively. There were 85 episodes of decompensations. The commonest precipitating factor was drug disco ntinuation followed by infection and arrhythmia. Most episodes have mu ltiple causes for deterioration. Critical evaluation and education of patients during follow up is recommended.