A cross-sectional study of the spectrum, aetiology and clinical characteristics of adult mitral valve disease at Chris Hani Baragwanath Academic Hospital

Banderker, Ebrahim
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Background: There is a scarcity of data regarding the current demographic and clinical characteristics of patients with mitral valve disease (MVD) at Chris Hani Baragwanath Academic Hospital (CHBAH). In this research report we aimed to systematically document the demographic, clinical and echocardiographic characteristics of current patients with adult MVD at CHBAH. Methods: This was a cross-sectional descriptive study of adult MVD, conducted at CHBAH outpatient’s valve clinic (December 2018-March 2019). Results The study included 134 patients (mean age 50 ± 13.3 years, 77% females). Majority were of African ethnicity (96%) in the New York Heart Association(NYHA) class II (54%). Dominant lesion was mitral regurgitation (39%) followed by mixed MVD (38%) and mitral stenosis (23%). The main aetiology of MVD was rheumatic heart disease (80%), mitral valve prolapse was noted in 11 % and myxomatous degenerative disease was present in 6%. Infective endocarditis was noted in 3%. Thirty per cent of the patients had concomitant involvement of other valves. Hypertension (30%) and human immunodeficiency virus (12%) were main co-morbidities. Heart failure was present in 78% at index hospitalisation. Fourteen patients were on rheumatic fever prophylaxis. MVD was complicated with pulmonary hypertension (28%) and atrial fibrillation in 14% of patients. Conclusion: The current patients with MVD tended to be older females with co-morbidities. The predominant aetiology was chronic rheumatic heart disease and acute rheumatic fever was rare
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilment of the requirements for the degree of Master of Medicine in Internal Medicine, 2021