الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
ARF and RHD still constitute a major health problem in developing countries in spite of the fact that the disease prevalence has markedly regressed in western and industrialized countries. Consequently and with only a few notable exceptions, ARF and RHD are now largely diseases of developing countries and of underprivileged and indigenous populations of developed countries. In these areas, long term complications of the disease can still be detected. The most common complication was CHF and other complications included pulmonary hypertension, infective endocarditis, arrhythmias and thromboembolism.
Aim of the work:
The aim of the present work was to evaluate the prevalence of possible complications in children diagnosed to have rheumatic fever and rheumatic heart disease. The study covered patients having follow-up at the pediatric cardiology clinic in Alexandria University Children’s Hospital (AUCH).
Subject and methods:
In our study, we reviewed the files of 150 patients previously diagnosed with RF and/or RHD who attend our cardiology outpatient clinic in AUCH and we followed them up for the past 2 years to detect the natural history of their disease. 71 of our patients are males (47.3%) and 79 are females (52.7%). Clinical examination was performed during each follow-up visit and different diagnostic tools were used to regularly assess their condition e.g. lab tests, CXR, ECG and echocardiography.
Results:
Of the 150 children included in our study, 29 have had complications (19.3%) with CHF being the most common complication. At least 21of our patients had NYHA functional classification of class III or IV. Sixteen patients had pulmonary hypertension (10.7%). Other less common complications included infective endocarditis in 3 patients (2%), thromboembolic complications in 2 patients (1.3%) and arrhythmias in 2 patients (1.3%) with one patient having had atrial fibrillation.
On studying different parameters that would affect the natural history of the disease, we found out that the 2 most important predictors of the disease outcome were the severity of carditis at the disease onset and the adequacy of compliance to LAP. This finding is consistent with different studies performed worldwide. There was no significant association between the disease complication and gender of the patient or residence of the family, whether in a rural or urban area. Also presence of a family history of RF had no impact on the final outcome of the disease.