Valvular heart diseases areclinically important heart diseases chiefly found in young adults. During the ten years 1959 to 1968,the author has observed clinical features of 543 cases of valvular heart disease including surgical and autopsy cases at National Medical Center, andhas obtained the following results.
1) The incidence of sex were males 43.4% and females 56.6%.
Incidence of valvular disease were; mitra stenoinsufficiency 40.7%, mitral stenosis 31.8%, mitral insufficiency 14.9%, combined valvular disease 6.6 %, aortic insufficiency 2.7%, aortic stenoinsufficiency 1.8%, pulmonary stenosis 0.9% and aortic ste0.3% in that order. As for the age incidence, those in age bracket of 21 to 35 years were most predorainent and those both above and below this range were in a gradual decrease.
2) The following were found as etiological factors; rheumatic fever 44.7%, syphilis 0.5%, unknown fever 7.4% and unknown etiology 47%.
3) Histopathological findings of auricular appendage of 101 cases were followings; rheumatic endocarditis 87%, chronic non-specific end.ocarditis 4.9 % and no results 7.9%, of which 24 cases(23.8%) were with Aschoff body, who were in the relatively young age group.
4) Histopathological findings of autopsy cases(39 cases) revealed followings; rheumatic endocarditis 89.7%, arteriosclerotic heart disease 2.6% and no results 7.7%.
5) In the past history of valvular heart disease patients, following were observed; rheumatic fever, unknown fever, multiple joint pain, malaria, tonsillitis, nephritis and others. Four to ten years were taken by 38.4% of all cases from their first finding of symptoms to their first visit to this hospital. They formed the majority of the total.
6) The main complication of valvular heart disease were congestive heart failure, auricular lation, cerebral embolism, subacute bacterial endocarditis and others.
7) Main symptoms were dyspnea, palpitation, fatigability, cough, chest pain, headache, dizziness, hoarseness, edema, hepatomegaly, lung congestion, sputum, arrhythmia, thrill, bloody sputum, cyanosis, clubbed finger and splenomegaly.
8) On physical examination, characteristic murmurs were audible, and obtained abnormal pulsation, thrill and accentuated pulmonic second sound.
9) In electrocardiogram, there were found to have abnormalities such as auricular fibrillation 31.1%, right ventricular hypertrophy, left ventrihypertrophy and change of T wave.
10) X-ray finding of heart revealed left atrial enlargement 53.2%, right ventricular hypertrophy 27%, left ventricular hypertrophy 15.5% and both ventricular hypertrophy 33.7%.
11) In the serum protein by paper electrophoresis, it was found serum albumin is on the decrease and r-globulin on the increase.
12) Venous pressure was elevated 53.5% of 62 cases.
13) Circulation time of arm to tongue was pro-longed in 69.6% of 56 cases.
|