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Rheumatic silent carditis: echocardiographic diagnosis and prognosis of long-term follow up.
[acute rheumatic fever]
Rheumatic
fever
and
rheumatic
heart
disease
continue
to
be
an
important
public
health
problem
in
developing
countries
.
Doppler
echocardiography
is
now
widely
used
for
early
detection
and
recurrence
of
clinical
evident
carditis
(
CC
)
and
silent
(
subclinical
)
carditis
(
SC
)
.
The
aim
of
this
study
was
to
determine
the
frequency
of
SC
and
to
compare
clinical
and
echocardiographic
features
of
CC
and
SC
.
A
total
of
156
consecutive
patients
diagnosed
with
acute
rheumatic
fever
were
included
in
the
study
.
The
patients
without
clinical
evidence
but
with
echocardiographic
findings
of
carditis
were
diagnosed
as
having
SC
.
Acute
rheumatic
fever
was
diagnosed
in
156
patients
,
and
103
of
these
(
66
%
)
had
carditis
.
The
prevalence
of
SC
was
28
.
2
%
among
these
103
patients
.
Seventy
-
four
of
the
patients
with
carditis
were
followed
up
for
>
1
year
,
and
20
of
those
had
SC
.
Valvular
regurgitation
disappeared
completely
in
18
.
5
%
and
improved
in
45
.
5
%
of
the
CC
patients
.
The
recovery
and
improvement
rates
in
the
SC
group
were
15
%
and
30
%
,
respectively
.
It
is
suggested
that
Doppler
echocardiography
be
performed
in
all
patients
with
suspected
acute
rheumatic
fever
for
early
detection
of
SC
.
Echocardiography
should
be
used
as
a
diagnostic
criterion
in
order
not
to
miss
a
diagnosis
of
SC
.
