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Echocardiographic diagnosis of rheumatic fever and rheumatic valvar disease

Published online by Cambridge University Press:  19 August 2008

Caio César Jorge Medeiros ,
Alvaro Villela de Moraes ,
Rachel Snitcowsky ,
Pedro Mauro Graziosi ,
José Albuquerque de Figueiredo Neto ,
José Rodrigues Parga Filho ,
Giovanni Bellotti  and
Fulvio Pileggi
Caio César Jorge Medeiros*
Affiliation:
Department of Pediatric Cardiology, Instituto do Coração, Hospital das Clinicas, Universidade de São Paulo, São Paulo
Alvaro Villela de Moraes*
Affiliation:
Department of Pediatric Cardiology, Instituto do Coração, Hospital das Clinicas, Universidade de São Paulo, São Paulo
Rachel Snitcowsky
Affiliation:
Department of Pediatric Cardiology, Instituto do Coração, Hospital das Clinicas, Universidade de São Paulo, São Paulo
Pedro Mauro Graziosi
Affiliation:
Department of Pediatric Cardiology, Instituto do Coração, Hospital das Clinicas, Universidade de São Paulo, São Paulo
José Albuquerque de Figueiredo Neto
Affiliation:
Department of Pediatric Cardiology, Instituto do Coração, Hospital das Clinicas, Universidade de São Paulo, São Paulo
José Rodrigues Parga Filho
Affiliation:
Department of Pediatric Cardiology, Instituto do Coração, Hospital das Clinicas, Universidade de São Paulo, São Paulo
Giovanni Bellotti
Affiliation:
Department of Pediatric Cardiology, Instituto do Coração, Hospital das Clinicas, Universidade de São Paulo, São Paulo
Fulvio Pileggi
Affiliation:
Department of Pediatric Cardiology, Instituto do Coração, Hospital das Clinicas, Universidade de São Paulo, São Paulo
*
Dr. Caio César Jorge Medeiros, Avenida Dr. Eneas de Carvalho 44, CEP -05403 São Paulo-SP, Brazil. Tel. 55-1 1-282-7766; Fax. 55-11-282-2354.
Dr. Caio César Jorge Medeiros, Avenida Dr. Eneas de Carvalho 44, CEP -05403 São Paulo-SP, Brazil. Tel. 55-1 1-282-7766; Fax. 55-11-282-2354.
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Summary

We studied 56 children echocardiographically, ages four to 15 years (mean nine years) with acute rheumatic fever to determine the extent of cardiac involvement. All had a clinical diagnosis of carditis. Mitral regurgitation was always present and was associated with aortic regurgitation in 53.6% and tricuspid regurgitation in 32.1%. Mitral valvar prolapse was observed in 18 patients 5(32.1%) and could not be differentiated from myxomatous prolapse in 10 (17.8%). Cordal rupture was detected in seven patients (12.5%), three of whom required surgical treatment. Other findings concerning the mitral valve were vegetations in two patients (3.6%), commissural fusion without stenosis in 36(64.3%), and mitral stenosis in four (7.1%). Heart failure was usually secondary to valvitis rather than myocarditis, and led to surgical treatment in seven patients. The myocardial function was depressed in only two patients. In both, the ejection function returned to normal after medical treatment. Echocardiography provides important information on the involvement of the heart in acute rheumatic fever, helping to determine prognosis and the results of treatment.

Keywords

Echocardiographyrheumatic fevervalvopathycarditis
Type
World Forum for Pediatric Cardiology Symposium on Rheumatic Fever
Information
Cardiology in the Young , Volume 2 , Issue 3 , July 1992 , pp. 236 - 239
Copyright
Copyright © Cambridge University Press 1992

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