Abstract:
Introduction: Cardiac arrhythmias are clinical entities that producing symptoms and complications importance being ranked in the top responsible for sudden death heart disease in adults. It is
known that rheumatic heart diseases are associated frequent with cardiac arrhythmias, caused by organic
heart involvement, followed by hemodynamic and electrophysiological disturbances.
The aim of study: To determine the characteristics of arrhythmias in patients with rheumatic
mitral valve diseases.
Materials and methods: The study group included 50 patients with mitral valve disease
evaluated by the questionnaire, which included general data, history of the disease, physical
examination and the results obtained by laboratory investigations. Depending on the prevalence of
involvement patients were divided into group I - 37 patients with mitral stenosis and group 1 1 -1 3
patients with mitral regurgitation.
Results: Mean age of study group was 49.3 ± 0.02, the ratio women: men being 2:1. Medical
history revealed acute rheumatic fever in childhood in 17 (34%) patients and prosthetic valve
replacement in 18 (36%) cases. Analyses of the residence demonstrated that most patients with
mitral valve disease come from urban areas in both groups: 26 (72.9%) and 7 (53.84%) in group I
and II, respectively. Patient complaints revealed clinical manifestations more expressed in mitral
stenosis group: palpitations had 35 (94.55%), dyspnea - 36 (97.27%) patients, while in mitral
regurgitation predominated dizziness in 12 (92.32 %) cases. According NYHA classification in
mitral stenosis patient’s functional class was more advanced: III degree in 15 (40.51%) vs. 3
(23.03%) patients with mitral insufficiency. ECG analysis found that in the group with mitral
stenosis predominate arrhythmias 36 (97%) patients, whereas in the group with mitral regurgitation
- conductibility disturbances, detected in 9 (69%) patients. Chronic atrial fibrillation and complete
left bundle branch block o f Hiss were the most common deviations in mitral stenosis, found in 20
(54%) and 8 (21.62%) respectively. AV blocks were identified only in mitral regurgitation - 6
(46.15%) patients. According to CHADS2 score and Birmingham SCCHA2DS2VASc scheme we
determined that high thromboembolic risk (3 points) is more prominent in mitral stenosis in 18
(48.33%) vs. 3 (23.0%) patients with mitral insufficiency.
Conclusion: Rheumatic mitral heart diseases usually associated with cardiac arrhythmias. In
mitral stenosis is more common atrial chronic fibrillation, whereas AV blocks are characteristic for
mitral insufficiency patients. Thromboembolic risk is higher in mitral valve stenosis.
