Clinical and echocardiographic characteristics of patients who developed adverse events following Benzathine penicillin G injection for secondary prophylaxis of rheumatic heart disease: a cross-sectional study from three university hospitals in Ethio

We hypothesise that the coexistence of severe valve lesions with concomitant advanced HF may be an essential risk factor in BPG injection-related deaths rather than the presence of severe valve lesions alone. Heart failure and a failure of the compensatory mechanisms in BPG injection-related adverse circulatory reactions in advanced RHD with HF could be one of the major causes of these deaths. According to the literature, we recommend that patients with advanced RHD receive special attention regarding secondary BPG prophylaxis. For the introduction of less painful BPG injection, like the subcutaneous technique, further research is needed.