Atrial Fibrillation in Rheumatic Heart Disease - Clinical and Echocardiographic study

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Idris Osman Okud Mohammed
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University of Khartoum
Background: Rheumatic heart disease still is a major health problem in developing countries. One of its serious complication is atrial fibrillation, it has high incidence of morbidity and mortality. Its treatment is another hurdle specially in countries such as Sudan. It has been noticed by some workers that AF occurs in relatively young Sudanese patients with RHD and that many young patients and children develop congestive cardiac failure in the absence of AF hence the objective is to find out how left atrial size plays a role in the development of rheumatic atrial fibrillation and to report the echocardiographic findings in these patients. Methods: This was descriptive prospective study conducted in 200 Sudanese patients with rheumatic heart disease and atrial fibrillation in Elshaab and Ahmed Gasim Teaching Hospitals in the period from June 2003 to February 2004.Cases were seen in the referred clinic as well as admitted cases history,physical examination, ECG, and transthoracic echocardiographic were used in the study . Result: in our study we found that, the ratio of female to male was 1.7:1, the frequency of occurrence of atrial fibrillation due VIII to rheumatic heart disease was high in older patients. Those patient who were above 30 years or more had greater chance to develop AF. There is correlation between the development of atrial fibrillation and left atrial size the greater the left a trial size the greater the chance to develop AF in patients with R.H.D. Patient with atrial fibrillation and had normal left atrial size were found to be 2.5% in this study. All patients had mitral valve involvement, 183(91.5%) had mitral valve stenosis, 115 patients had severe mitral stenosis, 71 patients had aortic valve lesion, left atrial thrombus was found in 18 patients (9%). Conclusion: Rheumatic heart disease has high predilection to occur in patients, whose ages were above 30 years. There is correlation between its occurrence and left atrial size, the degree of mitral valve stenosis had another role for AF development.
A thesis Submitted in partial fulfillment for the requirements of the Degree of Clinical MD in Medicine, April, 2004
University of Khartoum Atrial Fibrillation Rheumatic Heart Disease echocardiography
Idris Osman Okud Mohammed, Atrial Fibrillation in Rheumatic Heart Disease - Clinical and Echocardiographic study. – Khartoum : University of Khartoum, 2004. - 113 P. : illus., 28 cm., M.Sc.