Presentation and outcome of patients managed for Rheumatic fever and Rheumatic heart disease at Ahmadu Bello University Teaching Hospital Zaria.

Abstract

Background: Rheumatic heart disease occurs as a sequel to acute rheumatic fever. Many cases of acute rheumatic
fever, however, go undiagnosed as many patients present with otherwise common symptoms and in the absence of
overt carditis may go undetected. Most cases present late following the development of valvular damage. A high
index of suspicion is key in managing this disease. Aim: To determine the Presentation and outcome of patients
managed for Rheumatic fever and Rheumatic heart disease at Ahmadu Bello University Teaching Hospital Zaria.
Methodology: A retrospective study was done using information collected from patient records from the Paediatric
cardiology ward and clinic of Ahmadu Bello University Teaching Hospital Zaria over 4 years from March 2015 to
March 2019. Results: Eight per cent of the total patients seen in the cardiopulmonary clinic had rheumatic heart
disease. Fifty-one patients were diagnosed with rheumatic heart disease, forty-five patients presented with
established chronic rheumatic valvular involvement and six had acute rheumatic fever. The mean age (±SD) at
presentation was 10.7 ± 3.2 years. There was a slight female preponderance M: F 1:1.3 and most patients (88 percent)
presented late (already having valvular disease). Most patients had mixed mitral valve disease. The clinic dropout
rate was 39 percent while the mortality rate was 25 percent. All patients received medical management, the mortality
rate was 25 % (13 patients) while only 3.9 per cent received successful surgical management. Conclusion:
Rheumatic heart disease is the commonest preventable and curable type of acquired heart disease, yet the outcome of
care provided in our settings remains poor. There is a need to increase awareness, diagnosis and available treatment of
rheumatic heart disease.