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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
"aortic regurgitation and tricuspid regurgitation"
symptom
acute rheumatic fever
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