A Clinical Study of Congestive Cardiac Failure in Rheumatic Heart Disease

Abstract

Introduction: Congestive cardiac failure is the failure of the heart to pump blood at a rate commensurate with the requirements of the metabolizing tissue and or its ability to do so requires an abnormally elevated pressure. CCF once sets in, pressure with malignant progression with one year mortality of 38% and 15% and six year mortality of 80% and 65% in men and women respectively. Acute rheumatic fever(ARF) and its sequel Rheumatic Heart Disease(RHD) may impair myocardial function to precipitate failure.

Aim: To study clinical features of Congestive Cardiac Failure in Rheumatic Heart Disease.

Methods: A prospective study with 50 patients admitted between August 2006 and September 2008 in Shree Birendra Hospital formed the subject of this study.

Patients of rheumatic valvular heart disease of both sexes in congestive cardiac failure at the time of admission or who developed failure during hospitalization were taken into the study. Detailed history was taken from all patients. Detailed examination was done in all patients with emphasis in cardiovascular and relevant system. Modified Framingham heart study criteria was used for the diagnosis of CCF.

Results: A total of 50 patients with RHD in CCF were the subject of study. The average age was 33.78 years. The presenting clinical features of the patients were breathlessness on exertion and it was the commonest presenting complaint and was present in all patients. Palpitation was present 37 of 50 patients(74%). Basal crepitation was the commonest clinical sign present and 29 of 50 patients(58%) had the raised jugular venous pressure. Mitral valve was the commonest valve involved (with/without) other valves) and was seen in 94% (47) patients.

Key words: Congestive Cardiac Failure; Rheumatic Heart Disease

DOI: http://dx.doi.org/10.3126/mjsbh.v9i2.5019

Medical Journal of Shree Birendra Hospital Vol.9(2) 2010: 8-12