42 Echocardiographic screening for rheumatic heart disease among asymptomatic adults: study from a region with high prevalence of echocardiographic rhd in asymptomatic school children

Purpose Several studies, including our own, have reported a high prevalence of rheumatic heart disease (RHD) in school children on echocardiographic screening. A long term follow up of such children will be ideal to understand the natural history these abnormalities. Screening adults living in the same region may provide some insight into the natural history. Methods We carried out a cross sectional survey among asymptomatic adults 18–25 years of age in a pre identified area of northern part of India where an echocardiographic screening among school children had detected a high prevalence of RHD. An echo Doppler was performed by an experienced cardiologist. A diagnosis of RHD was made using the WHF criteria; it was divided into ‘definite RHD’ and ‘borderline RHD’. Results A total of 1490 adults have been screened. The mean age was 20.7±2.6 years, 50% were males. Clinical examination detected RHD in four cases (clinical prevalence: 2.7/1000). Using the WHF criteria, RHD was diagnosed in 21 cases (echo prevalence:14/1000; 95% CI: 8.7–21.5/1000), 9 were diagnosed as definite RHD and 12 as borderline.. RHD was more common in females (p<0.01). Conclusion This preliminary work demonstrates high prevalence of RHD among asymptomatic adults in this region of northern part of India where an earlier study had shown high prevalence in school children. This data may be useful to understand the natural history of mild, subclinical RHD since it may act as a surrogate marker for long term follow up of children diagnosed to have RHD on screening echocardiography.