The efficacy of echocardiographic criterions for the diagnosis of carditis in acute rheumatic fever.

Abstract:

BACKGROUND:There is a great need for echocardiographic criterions for accurate diagnosis of carditis in acute rheumatic fever. AIM:To test the efficacy of proposed echocardiographic criterions for the diagnosis of carditis. MATERIALS AND METHODS:We studied 333 patients suspected of having acute rheumatic fever, undertaking detailed clinical examination, laboratory tests and meticulous echocardiography in each case. We used previously established echocardiographic criterions for the diagnosis of carditis and subclinical valvitis. In 220 cases (66.06%), both the echo criterions, and the Jones' criterions, gave positive results. In 52 cases (15.61%), we found evidence of subclinical carditis, in that clinically no murmur was heard, meaning the Jones' criterions were negative, but the echocardiographic evaluation was positive. In 4 patients clinically diagnosed as having carditis, the Jones' criterions were positive, but echocardiographic evaluation showed them to have congenitally malformed hearts. In another 57 cases (17.11%), the Jones' criterions were negative, as were the results of echocardiographic evaluation. These patients were taken as control subjects. On this basis, the echocardiographic criterions had sensitivity of 81% and specificity of 93%. CONCLUSION:Using our echocardiographic criterions, it is possible to make a precise diagnosis of carditis or subclinical valvitis. Hence, echocardiography should, in future, be included as a major criterion in the Jones' system.

journal_name

Cardiol Young

journal_title

Cardiology in the young

authors

Vijayalakshmi IB,Vishnuprabhu RO,Chitra N,Rajasri R,Anuradha TV

doi

10.1017/S1047951108003107

subject

Has Abstract

pub_date

2008-12-01 00:00:00

pages

586-92

issue

6

eissn

1047-9511

issn

1467-1107

pii

S1047951108003107

journal_volume

18

pub_type

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