Acquired heart disease in Ugandan children.

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Abstract
Acquired heart disease is a major pedlatric problem of the tropics and subtropics. Excluding the commonest etiological factors that may lead to heart disease in children[long dash]severe electrolyte imbalance, protein-calorie malnutrition, anemia, and acute nephritis, 50 Instances of acquired cardiac disorders were seen in a 1-yr. period in African children in Kampala, Uganda. Although the exact diagnosis was not made clinically in many of the patients with chronic carditls, it was established beyond question that the most prominent etiological factor was rheumatic fever, which was diagnosed in 23 of the 50 patients, suspected in 5 who had both mitral insufficiency and mitral stenosis, and might also have been the aetiological factor in some of those with pure mitral insufficiency. This was an unexpected finding, since most of the published cardiology reports from Uganda have emphasized endomyocardial fibrosis. The etiology of endomyocardlal fibrosis is not known, but correction of the K and Mg deficiency that commonly occur during prolonged gastroenteritis among children of the lowest income group in the tropics might help to protect the heart from scarring. The prevention of initial and recurrent episodes of rheumatic fever requires an increase in health education, clinic facilities, and adequate supplies of penicillin and the sulphonamides.