CARDIOVASCULAR JOURNAL OF AFRICA • Volume 35, No 2, May – August 2024 94 AFRICA level of education was poorly documented in patient records. IE patients were under-represented in this study as the majority of these patients do not present to an out-patient clinic. The echocardiographic technicians had varying levels of expertise and experience. Due to the lack of an existing database, we did not have access to information on mortality and hence were unable to report on this finding. Conclusions We noted a high burden of chronic RHD in the current population with MVD at our peri-urban institution. These patients were older with multiple co-morbidities and the majority presented in HF at the index admission. Delay to definitive surgical treatment remains an important concern and was responsible for considerable morbidity in this study. Prof Ruchika Meel was the recipient of the Carnegie Post-doctoral Fellowship grant. References 1. 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