Title : Demographic and disease characteristics of paediatric rheumatic heart disease (RHD) patients requiring mitral valve surgery in Malaysia
Abstract:
Rheumatic heart disease (RHD) remains a major cause of acquired heart disease in children in low and middle-income countries. Demographic and clinical profiling can help optimise screening, referral, and management strategies. The aim of this research was to describe the demographic profile and disease patterns of children with RHD who underwent mitral valve (MV) repair at a national referral centre in Malaysia. We retrospectively reviewed 53 paediatric patients (<18 years old) who underwent MV repair for RHD at the National Heart Institute (IJN) from 2011–2016. Data on age, sex, ethnicity, New York Heart Association (NYHA) classification for heart failure, echocardiographic findings, and RHD classification were analysed. The cohort had a mean age of 12.6 years; 56.6% were female. Ethnic distribution was predominantly Malay (79.2%), with 20.8% non-Malay including indigenous children and international patients. Most patients presented in NYHA class II or higher, and 89% had severe mitral regurgitation. Only 49% fulfilled the full Jones Criteria at diagnosis. Leaflet thickening (60%) and prolapse (62%) were the most frequent echocardiographic features. Aortic valve involvement was noted in over 50% of cases. No in-hospital mortality was reported. Children requiring MV repair for RHD in Malaysia predominantly presented in late childhood with advanced disease. A significant proportion did not meet classical diagnostic criteria, and echocardiography played a pivotal role in decision-making. These findings underscore the need for targeted screening, especially among high-risk ethnic groups, and broader access to echocardiographic assessment in endemic areas.
Keywords:
Rheumatic heart disease, mitral valve repair, Malaysia, paediatrics, epidemiology, diagnosis
