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Doppler echocardiography imaging in detecting multi-valvular lesions: a clinical evaluation in children with acute rheumatic fever.
[acute rheumatic fever]
Doppler
echocardiography
has
been
demonstrated
to
be
accurate
in
diagnosing
valvular
lesions
in
rheumatic
heart
disease
(
RHD
)
when
compared
to
clinical
evaluation
alone
.
To
perform
Doppler
echocardiography
in
children
clinically
diagnosed
by
the
Jones
criteria
to
have
acute
rheumatic
fever
(
ARF
)
,
and
to
then
compare
the
effectiveness
of
echo
in
detecting
single
/
multi-valvular
lesions
with
that
of
the
initial
clinical
evaluation
.
We
enrolled
93
children
who
were
previously
diagnosed
with
ARF
by
clinical
examination
.
Presence
of
valvular
lesions
were
enlisted
,
first
by
clinical
auscultation
,
and
then
by
performing
Doppler
echocardiography
.
We
found
that
Doppler
echocardiography
was
a
sensitive
technique
,
capable
of
detecting
valvular
lesions
that
were
missed
by
clinical
auscultation
alone
.
Echocardiography
of
patients
with
carditis
revealed
mitral
regurgitation
to
be
the
most
common
lesion
present
(
53
patients
,
56
.
98
%
)
,
followed
by
aortic
regurgitation
in
21
patients
(
22
.
6
%
)
.
The
difference
between
clinical
and
echocardiographic
diagnosis
in
ARF
children
with
carditis
was
statistically
significant
for
mitral
regurgitation
,
aortic
regurgitation
and
tricuspid
regurgitation
.
Clinical
auscultation
alone
revealed
4
cases
of
mitral
stenosis
,
39
mitral
regurgitation
,
14
aortic
regurgitation
,
9
tricuspid
regurgitation
;
in
contrast
,
echo
revealed
5
cases
of
mitral
stenosis
,
53
mitral
regurgitation
,
21
aortic
regurgitation
,
18
tricuspid
regurgitation
.
Doppler
echocardiography
is
a
more
sensitive
technique
for
detecting
valvular
lesions
.
In
the
setting
of
ARF
,
echo
enables
a
46
.
9
%
higher
detection
level
of
carditis
,
as
compared
to
the
clinical
examination
alone
.
Echo
was
very
significant
in
detecting
regurgitation
lesions
,
especially
for
cases
of
tricuspid
regurgitation
in
the
setting
of
multivalvular
involvement
.
The
results
of
our
study
are
in
accordance
with
previous
clinical
studies
,
all
of
which
clearly
demonstrate
the
advantages
of
Doppler
echocardiography
,
paving
the
way
for
its
probable
inclusion
as
one
of
the
Jones
major
criteria
for
diagnosing
ARF
.
Diseases
Validation
Diseases presenting
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated