TITLE:
Epidemiological Approach to Understand Rheumatic Heart Valve Disease: Case of Thoracic Cardiovascular Clinic of Fann Hospital (Dakar)
AUTHORS:
Marie Parsine Sall, Fatimata Mbaye, Mbacké Sembéne, Amadou Gabriel Ciss
KEYWORDS:
Rheumatic, Valves, Epidemiological, Diagnosis, Surgery
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.10 No.10,
October
30,
2020
ABSTRACT: Objective: Rheumatic heart disease is the major cause of heart valve disease in
developing countries. In Senegal, cardiac pathology is dominated by rheumatic
pathology whose hospital prevalence was estimated at 0.15%[1].
Epidemiological data on rheumatic heart valve disease (RHVD) are unfortunately
imprecise due to the lack of good quality data collection in a large number of
countries, especially in sub-Saharan areas and in Central Asia. The objective
of this epidemiological study is to collect data about rheumatic heart valve disease in our clinic which
is the only surgical center of Senegal. Patients and Methods: Our study
conducted between 2014 and 2017 involved a population of one hundred and
eighty-three patients with complete medical records, all followed at the
Thoracic and Cardiovascular Surgery Clinic at Fann Hospital for rheumatic valve
disease. This population was the subject of an epidemiological survey based on
a questionnaire covering clinical parameters as consanguinity, clinical signs,
diagnosis and surgical intervention. Results: Our work is an epidemiological
study involving one hundred and eighty-three (183) patients with various types
of rheumatic valve disease, followed at the Thoracic and Cardiovascular Surgery
Clinic at Fann Hospital, and who responded to a questionnaire about clinical
aspects of this disease. Our results showed 5.46% of family cases, of which
2.18% came from consanguineous marriages. Mean age at onset of clinical signs
was 14 ± 9 years with 14.20% before 6 years of age,
65.91% between 6 and 21 years
and 19.89% in adulthood. Average age of diagnosis was 21 ± 11 years with an average delay between
diagnosis and intervention of 10 years ± 14. Mitral stricture (22.5%) was the most common diagnosis, followed by
mitral disease (17.9%) and mitral regurgitation (6.9%). Surgical procedures
involved 31.8% of mitral valve, 8.79% of aortic valve, 12.09% of mitral and
aortic valves, 13.74% of mitral and tricuspid valves, 2.75% of 3 valves mitral,
aortic and tricuspid. 27.49% of patients were awaiting surgery. Conclusion: It appears that a considerable effort should be made to prevent the pathology,
to make population aware of the clinical signs and to improve the accessibility
of patients to surgical procedure. These different actions would reduce the
incidence and prevalence of the disease in Senegal.