High prevalence of tricuspid valve disease among rheumatic heart disease patients in Yemen

BackgroundRheumatic heart disease is common in Yemen with high prevalence among children and young adult that make social and economic burden over the patient, his family, the community and the country. Tricuspid valve disease receive less attention as compared to the primary left sided disease. It is frequently labeled as the forgotten valve because appropriate management and surgical correction is often ignored.AimThe aim of this work was to determine the prevalence of tricuspid valve disease among rheumatic heart disease patient in the cardiac center in TMGH outpatient. STUDY DESIGN: descriptive prospective studyMethodswe enrolled all adult patients who had been referred to an echocardiography outpatient Echo Lab. Over 3 months time from 1/5/2009 to 1/8/2009 Setting: cardiac center,Al-Thawra General Hospital, Sana’a city,Yemen.Results172 cases (34.4%) were having Rheumatic heart disease out of 500 cases referred to the Echo lab. Organic tricuspid valve disease was found in 33 patients (19.2%). 88 cases (51.1%) were having functional (secondary) tricuspid valve disease. while normal tricuspid valves were found in 51 cases (29.7%). Pulmonary Hypertension was found in 115 cases (66.8%); 27 cases had sever PH (15.7%),25 cases had moderate PH(14.5%),63 cases had mild PH(36.6%) and 57 cases had normal pulmonary tension.Right atrial enlargement was found in 24 cases (14%).while no comment on atrial size in 29 cases (16.9%),119 cases were having normal RA size. 20 patients (11.6%) were having right ventricular enlargement, no comment on 31 cases (18%) while 121 cases had normal RV size.ConclusionHigh prevalence of tricuspid valve disease among the rheumatic heart disease either organic affection or functional (secondary).Tricuspid Valve Diseases need special care before surgery as both organic and functional tricuspid diseases need to be managed surgically in most cases