COMPREHENSIVE ASSESSMENT OF RHEUMATIC HEART DISEASE AT THE STATIONARY STAGE
KURBONOVA F.U., SHUKUROVA S.M., RADZHABOVA G.M.
Department of Therapy and Cardiorheumatology of the State Education Establishment «Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan»
Aim. To study the prevalence, frequency, risk factors, and complications of rheumatic heart diseases (RHD) in the structure of rheumatic diseases (RD).
Material and Methods. A retrospective analysis of medical records (n-352) of patients for the period 2013-2015 was performed. Women 244 (69,3%), men 108 (30,7%), average age-51,6±0,5; residents of the village – 215, residents of the city -137. Statistical reports of therapeutic services of the National Medical Center for a 10-year period (2006-2015) were studied. The total number of hospitalized patients with rheumatic diseases and the proportion of patients with RHD to the general structure of hospitalizations and their outcomes were analyzed. The analysis of medical histories was carried out using a specially developed card, which included demographic (gender, age, social origin), anamnestic, clinical, instrumental and laboratory characteristics.
Results. Of the 352 patients with rheumatic heart diseases, mitral valve disease occurred in 188 patients: mitral stenosis in 69, mitral insufficiency in 47, and combined mitral valve disease in 72 patients. 141 patients had combined disease of the mitral and aortic valves and 23 patients had combined disease of the aortic valve.
In patients with RHD, the provoking factors were: tonsillitis 65%, overcooling 50%, physical fatigue 38% and ARVI 47%. In 25,6% of cases, patients associated the onset of the disease with childbirth, surgery and exacerbation of comorbidities. In 10,8% of cases, the cause was not established. 340 observed patients (96,5%) had various stages of chronic heart failure (CHF): the first 93 (27,3%), the second 210 (61,7%), the third 36, the fourth – 2.
Conclusion. In the RHD structure, mitral valve damage occurs in the majority (93,4%) of patients, and in 96,7% of patients develop CHF. RHD was accompanied by high comorbidity (69,6%) and the presence of various complications. Arrhythmias such as atrial fibrillation (AF) and ventricular extrasystoles were observed with the highest frequency – 59,4%.
Key words: rheumatic heart disease, chronic heart failure, risk factors, comorbidity
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Information about authors:
Kurbonova Farzona Ubaydullaevna – Assistant at the Department of Therapy and Cardiorheumatology of the State Education Establishment «Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan»; tel.: (+992)907500133; e-mail: email@example.com
Shukurova Suraye Maksudovna – Head of the Department of Therapy and Cardiorheumatology of the State Education Establishment «Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan»; Corresponding Member of the Academy of Medical Sciences of the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan, Doctor of Medical Sciences, Full Professor; e-mail: firstname.lastname@example.org
Radzhabova Gulnoz Marufkhodzhaevna – Assistant at the Department of Therapy and Cardiorheumatology of the State Education Establishment «Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan»