FEATURES OF THE COURSE OF THE CHRONIC RHEUMATIC HEART DISEASE IN MODERN CONDITIONS

Yakimenko Е. А., Zakatova L. V., Antipova N. N., Serebriakova А. А., Yefremenkova L. N., Klochko V. V., Tabinskiy S. I. FEATURES OF THE COURSE OF THE CHRONIC RHEUMATIC HEART DISEASE IN MODERN CONDITIONS. Актуальні проблеми транспортної медицини / Actual problems of transport medicine / 2019;3(57):36-43. ISSN 1818-9385

DOI http://dx.doi.org/10.5281/zenodo.3465467

http://aptm.org.ua

УДК 616.12-002.77-036.12

FEATURES OF THE COURSE OF THE CHRONIC RHEUMATIC HEART DISEASE IN MODERN CONDITIONS

Yakimenko Е. А., Zakatova L. V., Antipova N. N., Serebriakova А. А., Yefremenkova L. N., Klochko V. V., Tabinskiy S. I.

Оdessa State Medical University, Оdessa, Ukraine

Summary

The problem of a chronic rheumatic heart disease has not lost the relevance in view of the fact that this disease have people of young working-age at whom it can lead to an early invalidization and premature death. The prevalence of a chronic rheumatic heart disease among adult population of Ukraine (18 years and older) is 397.6 on 100 thousand population, and incidence — 6.4 on 100 thousand adult population. In Ukraine the specific weight of a chronic rheumatic heart disease as the reasons of primary disability among all population and employable population continues to remain the same (0.4 %) without tendency to decrease. At 30-50 % of patients with rheumatic heart diseases in the anamnesis do not reveal data on the postponed acute rheumatic fever. For the last decade the incidence of a chronic rheumatic heart disease decreased by 60 %, however, mortality increased by 78 %.

Dynamics of negotiability to rheumatological departament of patients with acute and chronic forms of rheumatism and feature of a course of a chronic rheumatic heart disease in modern conditions was analysed. It was established that now the chronic rheumatic heart disease develops without the previous acute rheumatic fever, it is diagnosed at a stage of the formed heart disease or development of disturbances of a heartbeat and, is compensated throughout a long time. The clinical example of the patient having a chronic rheumatic heart disease is provided. Feature of this clinical case are: the long asymptomatic course of damage of heart, initially revealed mitral and aortal defect at the age of 51 year with prevalence of a mitral stenosis complicated by fibrillation of auricles; a mitral commissurotomy at the age of 56 years with fast development of a restenosis (in 58 years) when prosthetics of the mitral valve was offered; many years (up to 76 years) rather satisfactory condition with sharp deterioration within one month, due to the revealed critical mitral stenosis, heart failure ІІІ St.

Key words: acute rheumatic fever, chronic rheumatic heart disease, features of a current, clinical case.