Chronic Rheumatic Endocarditis an Echocardiographic Study.

Abstract

Chronic rheumatic endocarditis (CRE) is a major problem especially in the under developed countries”. The prevalence rate in India is about 6.4 per 1000 rural population and increases with age upto 25 years 3. While it has been predominantly eradicated from the west it is a common complication of rheumatic fever (RF) and the leading cause of cardiac death in the young population in the underdeveloped countries4’5”. Bland and Jones showed that following acute rheumatic fever after 20 years 45% had evidence of CRE3. About 3-5% of patients with group-A beta hemolytic streptococci develop RF’ but the incidence increases to about 50% in the first year following the initial attack of RF and falls quite steeply reaching a plateau at 10% after 4 or 5 years . Widespread use of echocardiography and Doppler flow studies have highlighted this problem and enabled an early and accurate anatomical diagnosis. The incidence of various valvular involvement in patients with CRE presenting with cardiac murmurs is presented.