Follow up study of acquired valvular heart disease.

In patients with acquired valvular heart disease detected by group cardiac examinations at school, we analyzed follow-up data obtained during school days as well as after graduation from senior high school. Of the 343 patients followed up after graduation from senior high school up to an age range of 20-38 years (mean: 29.3 years), 18 (5.2%) died, 16 (4.7%) deteriorated, 159 (46.4%) remained unchanged, 40 (11.7%) improved, 18 (5.2%) spontaneously recovered and 30 (9.7%) were treated surgically. Of patients who showed spontaneous recovery after graduation from senior high school, 16 cases (8.4%) had mitral regurgitation and 2 (3.6%) had mitral stenosis-regurgitation. In some patients, the disease type changed many years after graduation from senior high school. In particular, the appearance of stenosal lesions in the mitral or aortic valve was often delayed. The mean annual death rate for patients with acquired valvular heart disease (age range: 6-38 years) between April 1962 and March 1983 was 0.65%. The rate peaked at the 15-17 years age range. In recent years, the fatality rate has been falling and no deaths are seen in younger patients. In the past, the leading cause of death in juvenile patients with acquired valvular heart disease was the recurrence of rheumatic fever. For the past ten years, however, no death attributable to the recurrence of rheumatic fever has been registered.