Clinical Presentations, Echocardiographic Findings, and Complications of Rheumatic Heart Disease in Children Admitted to Gaafar Ibnauf Hospital, Khartoum, Sudan

Background Rheumatic heart disease (RHD) is the most common cause of acquired heart disease in children and young adults globally. Individuals with RHD are at increased risk of complications such as congestive heart failure, arrhythmia, stroke, and infective endocarditis. Methods This study reviewed clinical data and echocardiographic findings from reports of 78 pediatric patients diagnosed with RHD at Gaafar Ibnauf Children's Hospital in Khartoum State between 2019 and 2020. Sociodemographics, clinical, and echocardiographic data were analyzed using SPSS version 29 to identify disease patterns. Results The majority of patients in the study were from Gezira State (22.9%), followed by White Nile State (18.6%). The most common presenting symptoms were shortness of breath (SOB) (76.9%), cough (52.6%), and joint pain (42.3%). The predominant valvular lesions were combined mitral regurgitation (MR) and aortic regurgitation (AR) (50.6%), followed by isolated MR (11.7%). Most valvular lesions were complicated by heart failure (82.7%), pulmonary hypertension (78.7%), and recurrent acute rheumatic fever (ARF) (38.5%). Infective endocarditis was the most common in-hospital complication (56%), followed by arrhythmias (8%). Despite the reported complications, mortality remained relatively low, affecting only 4% of cases. Conclusion RHD affects children across different age groups, with SOB, cough, and joint pain being the most common reported symptoms. Congestive heart failure, pulmonary hypertension, and recurrent ARF were among the frequent complications. Echocardiography findings revealed that combined mitral regurgitation (MR) and aortic regurgitation (AR) were the most prevalent valvular abnormalities, with the mitral valve being the most severely affected. Infective endocarditis was the leading in-hospital complication of RHD, followed by arrhythmias.