Increased Prevalence of Severe Rheumatic Heart Disease Requiring Early Valve Replacement Surgery and Fragmented Germ Cells

Background: Patients requiring valve replacement at a younger age, for rheumatic heart disease was apparently increasing after the new age practice of contraception. Methods: In 2012, data of patients referred to tertiary care hospital from two cardiology screening camps conducted in the community, were analyzed for the severity of presentation of rheumatic heart disease and associated contraception status by dividing into the three age groups—20 - 35 years, 36 - 50 years, >51 years; ~400 patients attended the camps; 31 female and 2 male patients were referred to the tertiary care hospital for further evaluation and categorized treatment, including valve replacement surgeries; among the 33 referred patients, belonging to the three age groups, the data were analyzed for [if any] correlation of contraception status with severe rheumatic heart disease. 8 randomly chosen males, of the 3 age groups, from a different community, whose life partners had undergone sterilization, were assessed for their serum testosterone levels. Results: Among 20 - 35 years, 7 female patients with contraception required valve replacement surgeries [p < 0.0005]; among 36 - 50 years, 20 female patients required valve replacement surgeries [p < 0.0005]; whereas among >51 years, 3 female and 2 male patients without contraception received medical treatment only [p < 0.0005]. Conclusion: Concept is contraception with smashed fragmentation of germ cells, consequent reduced endogenous estrogen and androgen leading to defaulted genomic repertoire, deranged cell metabolism and increased tendency for fibrosis has resulted in increased prevalence of severe valve disease in younger age itself, requiring valve replacement.