Vijayaraghavan G, Cherian G, Krishnaswami S, SUKUMAR I P, John S
Br Heart J. 1977 Mar;39(3):294-8. doi: 10.1136/hrt.39.3.294.
This report describes 30 patients under the age of 30 years with rheumatic aortic stenosis, presenting with combined aortic and mitral stenosis. Three patients had additional tricuspid stenosis. Twenty-eight patients gave a history of rheumatic polyarthritis. The diagnosis was confirmed by right and left heart catheterisation in all. The murmur of aortic stenosis was not initially present in 8 out of 10 patients in congestive heart failure. Aortic valve calcification was not seen. Cineangiography showed a tricuspid aortic valve in all, unlike congenital aortic stenosis. A unique feature of this group was the raised pulmonary vascular resistance in 87 per cent of the patients. The present study shows that patients in India developing aortic stenosis after rheumatic fever do so early in the natural history of the disease.
本报告描述了30例30岁以下患有风湿性主动脉瓣狭窄且合并主动脉瓣和二尖瓣狭窄的患者。3例患者还存在三尖瓣狭窄。28例患者有风湿性多关节炎病史。所有患者均通过左右心导管检查确诊。10例充血性心力衰竭患者中，有8例最初未出现主动脉瓣狭窄杂音。未发现主动脉瓣钙化。与先天性主动脉瓣狭窄不同，心血管造影显示所有患者均为三尖瓣型主动脉瓣。该组患者的一个独特特征是87%的患者肺血管阻力升高。本研究表明，在印度，风湿热后发生主动脉瓣狭窄的患者在疾病自然史早期就会出现这种情况。
