Rheumatic fever and Rheumatic heart disease among clinically suspected patients with joint pain in a specialized hospital

Background: Rheumatic fever (RF) and rheumatic heart disease (RHD) are the leading causes of early cardiovascular morbidity and mortality especially in developing world. Recently more emphasis is given on the role of echocardiography for diagnosis of these diseases. Objective: Recent and reliable data and studies on RF and RHD are very limited in Bangladesh. Therefore, this study was done to diagnose rheumatic fever and rheumatic heart disease among clinically suspected patients. Methods: This cross-sectional study was conducted from February to June 2021 in National Center for Control of Rheumatic Fever and Heart Disease, Dhaka. A total of 250 patients irrespective of age and sex with complaints of joint pain and clinically suspected of RF and RHD were enrolled. Laboratory investigations including CBC with ESR, ASO titer, CRP, ECG and echocardiography were done. Results: Among the suspected patients, acute rheumatic fever without carditis was diagnosed in 10 (4%) patients and 15 (6%) had rheumatic heart disease with recurrent RF and carditis. Rheumatic fever with carditis were diagnosed in 63 (25.2%) patients; among whom 19 (7.6%) had clinical carditis and 44 (17.6%) were diagnosed as subclinical carditis. Acute rheumatic fever was diagnosed only within 5-20 years of age patient and 60% patients of RHD were found in 21-30 age groups. About half (49.20%) of the patients of rheumatic fever with carditis were between 11 to 15 years of age. Several abnormalities of heart valves were detected by Echocardiography; 78.2% of the patients of RF and RHD had mitral regurgitation and all the mitral stenosis cases were detected in patients with RHD. Combination of mitral regurgitation with aortic regurgitation and mitral regurgitation with mitral stenosis was also present. Conclusion: The findings of the study indicate that RF and RHD are not negligible in our country. Though the result does not indicate the prevalence or incidence; however, it highlights the need of systematic large-scale study with inclusion of echocardiography to find the prevalence of rheumatic fever and rheumatic heart disease in Bangladesh. Bangladesh Medical Res Counc Bull 2022; 48: 83-89