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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
.
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
