A Common Color Flow Doppler Finding in the Mitral Regurgitation of Acute Rheumatic Fever

1991 ◽  
Vol 8 (6) ◽  
pp. 627-631 ◽  
Author(s):  
NILI ZUCKER ◽  
BENJAMIN L. GOLDFARB ◽  
ELYAHU ZALZSTEIN ◽  
HAIM SILBER ◽  
MAYA ROVNER ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Color Flow

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.

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.

A case of acute rheumatic fever: Echocardiographic findings for mitral regurgitation in acute rheumatic carditis.

1987 ◽  
Vol 51 (12) ◽  
pp. 1393-1396 ◽  
Author(s):  
YASUHISA KAJINO ◽  
HAJIME IWAYANI ◽  
NORIYUKI HANEDA ◽  
MASAKAZU SAITO ◽  
TOSHIKAZU NISHIO ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Rheumatic Carditis ◽  
Echocardiographic Findings

Penicillin and Acute Rheumatic Fever

PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 506-507
Author(s):  
Bernard Boxerbaum
Keyword(s):  
Heart Disease ◽  
Mitral Regurgitation ◽  
Rheumatic Fever ◽  
Rheumatic Heart Disease ◽  
Acute Rheumatic Fever ◽  
Secondary Prophylaxis ◽  
Benzathine Penicillin ◽  
Childrens Hospital ◽  
Rheumatic Heart

Introduction of secondary prophylaxis for patients with rheumatic fever is felt to be a major reason for improved prognosis of rheumatic heart disease.1,2(p163) The article by Ginsburg et al,3 raising questions concerning the efficacy of this practice, has prompted me to report our experience in the Rainbow Rheumatic Fever Clinic, Rainbow Babies and Childrens Hospital, where more than 80% of the patients receive 1,200,000 units of benzathine penicillin intramuscularly every 28 days. Seventy percent of the patients with rheumatic mitral regurgitation have lost their murmur, and no patient receiving regular intramuscular prophylaxis has developed stenosis.4

Can subclinical valvitis detected by echocardiography be accepted as evidence of carditis in the diagnosis of acute rheumatic fever?

2001 ◽  
Vol 11 (3) ◽  
pp. 255-260 ◽  
Author(s):  
Süheyla Özkutlu ◽  
Canan Ayabakan ◽  
Muhsin Saraçlar
Keyword(s):  
Mitral Regurgitation ◽  
Acetylsalicylic Acid ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Clinical Evidence ◽  
Clinical Signs ◽  
Mitral Insufficiency ◽  
The One ◽  
Echocardiographic Findings

Aim: Subclinical valvar insufficiency, or valvitis, has recently been identified using Doppler echocardiography in cases of acute rheumatic fever with isolated arthritis or chorea. The prognosis of such patients with acute rheumatic fever and subclinical valvitis is critical when determining the duration of antibiotic prophylaxis. We aimed, therefore, prospectively to investigate the association of silent valvitis in patients having rheumatic fever in the absence of clinical evidence of cardiac involvement, and to evaluate its prognosis. Methods and Results: Between November 1998 and September 1999, we identified 26 consecutive patients with silent valvitis in presence of rheumatic fever but in the absence of clinical signs of carditis. The patients, eight female and 18 male, were aged from 6 to 16 years, with a mean of 9.9± 2.7 years. Major findings were arthritis in 16, chorea in 7, and arthritis and erythema marginatum in 1 patient. Two cases had arthralgia with equivocal arthritic signs and Doppler echocardiographic findings of pathologic mitral regurgitation. Silent pathologic mitral regurgitation was found in 12 cases, and aortic regurgitation in 2 cases. All patients with arthritic findings were treated with acetylsalicylic acid with one exception, this patient receiving both prednisone and acetylsalicylic acid. No antiinflammatory treatment was given to patients with chorea. After a mean follow-up of 4.52 months, valvar regurgitation disappeared in 4 patients, including the one with migratory arthralgia and no other major criterions. All six patients with chorea and silent carditis still have mitral insufficiency. Conclusion: Acute rheumatic fever without clinical carditis is not a benign entity. Doppler echocardiographic findings of subclinical valvar insufficiency, therefore, should be considered as carditis when seeking to establish the diagnosis of acute rheumatic fever.

M-mode, cross-sectional and color flow Doppler echocardiographic findings in acute rheumatic fever

1992 ◽  
Vol 2 (3) ◽  
pp. 229-235 ◽  
Author(s):  
Edison T Ty ◽  
Edgardo E. Ortiz
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Mitral Valve ◽  
Rheumatic Fever ◽  
Doppler Echocardiography ◽  
Acute Rheumatic Fever ◽  
Common Finding ◽  
Cross Sectional ◽  
Color Flow ◽  
Echocardiographic Findings

AbstractM-mode, cross-sectional and color flow Doppler echocardiography were performed in 28 patients with acute rheumatic fever. The patients were grouped according to the presence or absence of carditis and congestive heart failure. Abnormal echocardiographic findings were found in 25 patients (89%), including five with no carditis. M mode echocardiography showed significant cardiac enlargement in all patients with carditis, and in two patients with no carditis. The myocardial contractility, as based on ejection fraction and fractional shortening, was normal in all patients except one. Prolapse of the leaflets of the mitral valve (57%) and increased echogenicity of the leaflets of the mitral valve (36%) were the most common findings seen on cross-sectional echocardiography. Pericardial effusion was seen in six patients (21%), all with heart failure. Color flow and Doppler echocardiography showed that mitral regurgitation, which was seen in 24 patients (86%), was the most common finding. Aortic regurgitation was found in 17 patients (60%). The presence of congestive heart failure in patients with carditis was related to the severity of the valvar regurgitation and the number of valves involved. Echocardiographic evidence of rheumatic involvement of the heart may be observed even in the absence of clinical signs of carditis.

Fulminant mitral regurgitation due to ruptured chordae tendinae in acute rheumatic fever

2008 ◽  
Vol 44 (3) ◽  
pp. 134-137 ◽  
Author(s):  
Yvonne Anderson ◽  
Nigel Wilson ◽  
Ross Nicholson ◽  
Kirsten Finucane
Keyword(s):  
Mitral Regurgitation ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever

scholarly journals Clinical profile of acute rheumatic fever patients attending a tertiary care hospital in eastern Bihar, India

2017 ◽  
Vol 4 (5) ◽  
pp. 1218
Author(s):  
Shanker Suman ◽  
Rakesh Kumar ◽  
Divya Jyoti ◽  
Pramod Kumar Agrawal ◽  
Vishal Parmar
Keyword(s):  
Heart Disease ◽  
Mitral Regurgitation ◽  
Rheumatic Fever ◽  
Aortic Regurgitation ◽  
Rheumatic Heart Disease ◽  
Joint Pain ◽  
Acute Rheumatic Fever ◽  
Care Hospital ◽  
Autoimmune Reaction ◽  
Rheumatic Heart

Background: Acute rheumatic fever (ARF) is a multisystem disease resulting from an autoimmune reaction to infection with group A beta haemolytic streptococcus. Acute rheumatic fever commonly occurs between 5-14 years of age.1 The major concern relating to acute rheumatic fever is often not the episode itself but the long-term consequences of damage to heart valves (Rheumatic heart disease (RHD) that often results from recurrent episodes of acute rheumatic fever. Rheumatic heart disease (RHD) continues to be a major public health problem and a common cause of morbidity and mortality in many parts of India.2Methods: 50 consecutive patients admitted with the diagnosis of acute rheumatic fever in Medicine Department, Katihar Medical College and Hospital, Bihar, India were studied. A detailed clinical history of these patients including presenting symptoms were noted. Physical examination of all systems was done and a diagnosis of acte rheumatic fever was made according to WHO Criteria (2002-2003) for the diagnosis of rheumatic fever and rheumatic heart disease (Based on the Revised Jones Criteria). Echocardiography of all 50 patients were done.Results: Mean age of patients diagnosed with ARF was 14.20±7.02 years. Out of 50 patients, 32 (64%) were female and 18 (36%) were male. Joint pain was the commonest presenting complain, 35 (70%) patients, followed by fever in 21 (42%) patients. Among Jones major manifestations 36 (72%) cases had carditis, 32 (64%) had arthritis, 6 (12%) had subcutaneous nodules, 5 (10%) had erythema marginatum and5(10%) had Sydenham’s chorea. In patients with carditis, 25 (69.44%) had mitral regurgitation (MR) only while 10 (27.77%) had MR with aortic regurgitation (AR) and 1 (2.77%) patient had organic tricuspid regurgitation (TR) with mitral regurgitation and aortic regurgitation. Out of 36 patients with carditis, 10 (27.77%) patients did not have any clinical evidence of carditis and were detected by echocardiography only.Conclusions: Commonest complain in patients with rheumatic fever was joint pain followed by fever. In patients with carditis, all had mitral regurgitation(MR), with 1/3rd of these patients having associated aortic regurgitation(AR). 1/3rd of patients with carditis were detected by echo only and therefore, echo should be included in diagnostic criteria for acute rheumatic fever. None of the patients who developed rheumatic fever was on penicillin prophylaxis.

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