An echocardiography audit to determine and characterise rheumatic heart disease lesions since 2012

Abstract

Introduction:  Rheumatic heart disease is still a common problem in Zimbabwe. It has a significant mortality rate due to heart failure, stroke or endocarditis. Timely surgical interventions can reduce mortality. An echocardiography audit was performed to determine the proportion of patients referred for echocardiography who had a diagnosis of rheumatic heart disease, the pattern of valvular involvement and the presence of surgical indications on echocardiography.

Objective:  To determine the number of echocardiograms done in 2012 and the proportion with a diagnosis of rheumatic heart disease. To determine which valve lesions were present and whether there were any echocardiographic indications for surgical intervention.

Method:  A record review of all echocardiograms performed by the investigator during the period January to December 2012 was performed. A data collection form was used to extract the data and the findings were tabulated and analysed.

Results:  308 echocardiograms were performed by the investigator during the year of review. 236 of these were abnormal and rheumatic heart disease was diagnosed in 16% of them. The commonest valve lesion was mitral regurgitation and half of the patients had surgical indications. The common complications were pulmonary hypertension and left atrial enlargement.

Conclusion:  This audit shows that rheumatic heart disease is still quite common in patients referred for echocardiography. Lesions are severe and the majority of patients are in need of surgical intervention.