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My name is Emmanuel Rusingiza. I’m a pediatric cardiologist at Kigali University Teaching Hospital, Rwanda. I’m going to talk about the diagnosis and management of rheumatic heart disease.
Types of Valvular Diseases.
Rheumatic heart disease is the result of damage to the heart valve which appear after repeated episodes of acute rheumatic fever. Although initial attacks can lead directly to rheumatic heart disease, early diagnosis of rheumatic heart disease is very important. So that secondary prophylaxis can be started as soon as possible to help prevent the progression of the valve disease.
Echocardiography is an essential tool to confirm the diagnosis and to detect any progression of the valvular disease.
So now what are the types of rheumatic heart disease? The types of valvular rheumatic heart disease are the following. The mitral valve is the most affected in over 90% of cases of rheumatic heart disease. The next common affected valve is the aortic valve. And usually disease of the aortic valve is associated with the disease of the mitral valve.
The tricuspid and pulmonary valves are rarely directly affected. But the tricuspid regurgitation may appear in advanced mitral valve disease especially when there is severe pulmonary hypertension.
So the valvular lesions include the mitral regurgitation, which is found most commonly in children and young adults. The mitral stenosis, which represents longer term chronic changes to the mitral valve more commonly seen in adults. All the children can present both mitral stenosis and mitral regurgitation. Aortic regurgitation is not uncommon. And aortic stenosis is almost never seen as an isolated lesion.