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Prevalence and follow‐up of subclinical rheumatic heart disease among asymptomatic school children in a north‐western district of India based on the World Heart Federation echocardiographic criteria
Author(s) -
Choudhary Dinesh,
Panwar Sadik Raja,
Gupta Bal Kishan,
Panwar Raja Babu,
Gupta Rajeev,
Bhaya Maneesha,
Beniwal Rajesh,
Raja Panwar Vasim,
Sharma Arvind,
Gupta Jigyasa,
Nanda Navin C.
Publication year - 2021
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.15035
Subject(s) - medicine , subclinical infection , asymptomatic , pediatrics , heart disease , population , disease , regurgitation (circulation) , rheumatic fever , stenosis , environmental health
Background The present study is based on the World Heart Federation (WHF) echocardiographic criteria to assess the prevalence of subclinical rheumatic heart disease (RHD) and elucidate evolution of the disease when the cases were placed on appropriate antibiotic prophylaxis and regular follow‐up. The prevalence of subclinical RHD reported by previous active surveillance studies among asymptomatic school children is not comparable to our study because of major differences in screening methods. Methods A random inclusion strategy was adopted to recruit urban and rural school children of Bikaner district in the state of Rajasthan, India. The diagnosis of RHD was based on the echocardiographic criteria proposed by the WHF. All studies were reported on‐site by a single experienced cardiologist and the digitally preserved studies were reported by a second cardiologist off‐site. The final diagnosis was made by consensus. The second echocardiogram was performed for cases diagnosed with RHD after two years from start of study to document early evolution of the disease with ongoing antibiotic prophylaxis. Results A high prevalence of subclinical RHD was observed in the study population. Pathological mitral and/or aortic valve regurgitation was the commonest lesion, and a significant proportion of cases improved while on regular antibiotic prophylaxis. No case showed fixity of leaflets/ stenosis. Conclusion The prevalence of subclinical RHD is high in the study population, and the disease seems to regress over time in the presence of appropriate antibiotic prophylaxis.