Reversibility of mitral regurgitation following rheumatic fever: Clinical profile and echocardiographic evaluation

1995 ◽  
Vol 62 (6) ◽  
pp. 717-723 ◽  
Author(s):  
Ahmed S. Kassem ◽  
Tarek M. El-Walili ◽  
Salah R. Zaher ◽  
Mohammad Ayman
Keyword(s):  
Mitral Regurgitation ◽  
Rheumatic Fever ◽  
Clinical Profile ◽  
Echocardiographic Evaluation

Suspected acute rheumatic fever in a young man in England

2021 ◽  
Vol 14 (11) ◽  
pp. e244469
Author(s):  
Zak Michael Wilson ◽  
Katie Craster
Keyword(s):  
Chest Pain ◽  
General Practitioner ◽  
Mitral Regurgitation ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Supportive Therapy ◽  
Acute Hospital ◽  
Shortness Of Breath ◽  
Pleural Effusions ◽  
Pericardial Thickening

A 24-year-old fit and well Caucasian man was referred to acute hospital via his General Practitioner with chest pain, palpitations, shortness of breath and an antecedent sore throat. Investigations revealed pericardial and pleural effusions, pericardial thickening on MRI, mild mitral regurgitation on echocardiogram and a raised Antistreptolysin O (ASO) titre.He was treated as acute rheumatic fever (ARF) with a prolonged course of penicillin, supportive therapy with bisoprolol and colchicine with lansoprazole cover. The patient made a full recovery and subsequent cardiac MRI showed resolution of all changes.

OP-069 Clinical and Echocardiographic Evaluation of Silent Carditis in Children with Rheumatic Fever

2015 ◽  
Vol 115 ◽  
pp. S30
Author(s):  
Ramush Bejiqi ◽  
Ragip Retkoceri ◽  
Hana Bejiqi ◽  
Albiona Beha ◽  
Arber Retkoceri
Keyword(s):  
Rheumatic Fever ◽  
Echocardiographic Evaluation

Valvular heart disease

2012 ◽  
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Rheumatic Fever ◽  
Aortic Regurgitation ◽  
Valvular Heart Disease ◽  
Mitral Valve Prolapse ◽  
Mitral Stenosis ◽  
Acute Rheumatic Fever

General considerations 144Acute rheumatic fever 146Mitral stenosis: clinical features 150Mitral stenosis: investigations 152Mitral stenosis guidelines 156Mitral regurgitation 158Mitral regurgitation guidelines 161Mitral valve prolapse 162Aortic stenosis 164Management of aortic stenosis 168Aortic regurgitation 170Aortic regurgitation guidelines ...

Evaluation of subclinical valvar disease in patients with rheumatic fever

2003 ◽  
Vol 13 (6) ◽  
pp. 495-499 ◽  
Author(s):  
Suheyla Ozkutlu ◽  
Olgu Hallioglu ◽  
Canan Ayabakan
Keyword(s):  
Mitral Regurgitation ◽  
Rheumatic Fever ◽  
Aortic Regurgitation ◽  
Doppler Echocardiography ◽  
Acute Rheumatic Fever ◽  
Disease Treatment ◽  
Permanent Disability ◽  
Subclinical Disease ◽  
Diagnostic Criterion ◽  
Adequate Evidence

Carditis is the only manifestation of acute rheumatic fever that leads to permanent disability. Hence, its diagnosis is of paramount importance. Recently, it has been reported that Doppler echocardiography has disclosed subclinical valvar regurgitation in some patients with acute rheumatic fever manifested as isolated arthritis or pure chorea. The prognosis of such patients with acute rheumatic fever and subclinical valvitis is not clear. We aimed, therefore, prospectively to investigate the potential to diagnose patients with subclinical carditis. We examined 40 patients, aged from 7 to 16 years, with Doppler evidence of mitral and aortic regurgitation, but in the absence of any pathologic murmur. The major findings satisfying the Jones criterions were arthritis in 29 patients, chorea in 10 patients, and arthritis and erythema marginatum in one patient. Of the patients, 33 had mitral regurgitation, 6 patients had combined mitral and aortic regurgitation, and one patient had aortic regurgitation. The patients were followed over a mean period of 18.1 ± 13.9 months, the valvar regurgitation disappearing in 23 (57.5%). No significant differences were observed in the resolution of the valvitis between those treated with acetylsalicylic acid, steroids, or those receiving no treatment. It is noteworthy, nonetheless, that patients treated with steroids were the fastest to recover from valvitis (p < 0.05).Based on our study, we suggest that subclinical valvitis demonstrated by echocardiography should now be accepted as adequate evidence for the diagnosis of carditis, and become a major diagnostic criterion for acute rheumatic fever. When managing this group of patients with subclinical disease, treatment with steroids seems to have a role in promoting early resolution of the valvitis.

Subclinical rheumatic valvitis: a long-term follow-up

2003 ◽  
Vol 13 (5) ◽  
pp. 431-438 ◽  
Author(s):  
Cristina Costa Duarte Lanna ◽  
Edward Tonelli ◽  
Marcio Vinicius Lins Barros ◽  
Eugenio Marcos Andrade Goulart ◽  
Cleonice Carvalho Coelho Mota
Keyword(s):  
Mitral Regurgitation ◽  
Rheumatic Fever ◽  
Aortic Regurgitation ◽  
Confidence Intervals ◽  
Doppler Echocardiography ◽  
The Other ◽  
Control Group ◽  
Healthy Children ◽  
Long Term Follow Up

In order prospectively to investigate the frequency and evolution of subclinical valvitis, we selected 40 consecutive patients suffering their initial attack of rheumatic fever, seen in our clinic from 1992 to 1994, and followed-up until 2001, with a mean period of follow-up of 8.1 years, and a standard deviation of 0.6 year. We also assembled a matched control group of 37 healthy children and adolescents. We discovered a murmur of mitral regurgitation in 28 (70.0%) of the patients. In 3 (7.5%) of these patients, there was also a murmur of aortic regurgitation. In the group of 28 symptomatic patients, Doppler echocardiography showed mitral regurgitation in all, and aortic regurgitation in 17. In the group of 12 patients without clinical evidence of cardiac involvement, Doppler echocardiography identified mitral regurgitation in 2, isolated in one and associated with aortic regurgitation in the other. Thus, the frequency of subclinical valvitis was 16.7%. In patients with subclinical valvitis only the aortic regurgitation regressed during the period of follow-up. In the group of 28 symptomatic patients, mitral regurgitation disappeared in 6 (21.4%), aortic regurgitation in 7 of the 17 having this feature (41.2%), while 2 patients (7.1%) developed mitral stenosis. The sensitivity and specificity of cardiac auscultation were, respectively, 93.3%, with 95% confidence intervals between 72.3% and 97.4%, and 100%, with 95% confidence intervals between 65.5% and 100%, for the diagnosis of mitral regurgitation, and 16.7%, with 95% confidence intervals between 4.4% and 42.3%, and 100%, with 95% confidence intervals between 81.5% and 100%, for that of aortic regurgitation. We conclude that the Doppler echocardiogram is an important means of diagnosing and assessing the evolution of subclinical rheumatic valvar lesions, which are not always transient. We suggest that Doppler echocardiography should be performed in all patients with acute rheumatic fever. Subclinical valvitis should be considered as mild carditis, provided that strict criterions are observed in the differential diagnosis from physiological regurgitation, and Doppler echocardiographic findings are analyzed in the context of the other manifestations of the disease.

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