Clinical profile of children with rheumatic heart disease in Indonesia

Introduction: In developing countries, rheumatic heart disease (RHD) affects 19 per 100.000 children. There are few systematically collected data on children with RHD in developing countries. Objective: To describe the clinical profile of children with RHD in Indonesia. Method: A cross-sectional study was conducted on children diagnosed with RHD who came to the paediatric cardiology outpatient clinic of Dr. Soetomo General Hospital from June 2014 to June 2015. Demographic data and clinical characteristics of RHD were collected. Results: Fifty children were diagnosed with RHD during the study period. The median age was 10.9 years. Female to male ratio was 1.2:1. At the time of initial diagnosis, 28% children had acute rheumatic fever (ARF) and 72% had RHD. Major clinical manifestations were carditis (86%), polyarthritis migrans (10%) and chorea (2%). Minor clinical manifestations were fever (36%), arthralgia (8%). positive C-reactive protein (60%), elevated erythrocyte sedimentation rate (68%) and prolonged PR interval on electrocardiogram (2%). Raised anti-streptolysin O titre was present in 44%. The common valve lesions were MR (86%), tricuspid regurgitation (42%) and aortic regurgitation (38%). Conclusions: Carditis was the commonest major clinical manifestation in past ARF and MR the commonest valve lesion in children with RHD. Conclusions: Carditis was the commonest major clinical manifestation in past ARF and MR the commonest valve lesion in children with RHD.