[Epidemiology of mitral valve disease in pediatrics: a Lebanese study].

OBJECTIVE

To study the incidence, etiology, clinical signs and treatment of children with mitral valve disease in Lebanon.

METHODS

This is a retrospective study on a period of 9 years (between May 1, 1999 and April 30, 2008), including a group of children with congenital and acquired heart disease, consecutively enrolled in the National Register of Pediatric and Congenital Heart Disease, Lebanese Society of Cardiology.

RESULTS

2586 new patients aged 0-18 years were recorded. Among them, 128 (4.9%) had mitral disease. The causes were congenital in 65% of the cases (28% were associated with other congenital heart anomalies, especially a double outlet right ventricle) and acquired in 35% of the cases (91% were secondary to rheumatic fever). The diagnosis of the disease was fortuitous in 24% of the cases, and a murmur was discovered on auscultation in 53% of the cases. The majority of children showed mitral regurgitation (86%). The regurgitation was severe in 12% of the cases. Half of the children received medical or surgical treatment. The mortality of this disease reached 2%.

CONCLUSIONS

Congenital anomalies of the mitral valve are the most common cause of mitral regurgitation in children. Rheumatic disease remains another important cause of mitral disease in Lebanon. A high index of suspicion must exist, since the vast majority of diseases are found fortuitously or during simple auscultation.