Moe. Hilario et al., The value of echocardiography in the diagnosis and followup of rheumatic carditis in children and adolescents: A 2 year prospective study, J RHEUMATOL, 27(4), 2000, pp. 1082-1086
Objective. To evaluate echocardiographic/Doppler findings in patients with
rheumatic fever whether or not clinical manifestations of carditis were pre
sent, and the followup of these findings 24 months after the acute phase.
Methods. Twenty-two patients with rheumatic fever (13 boys, 9 girls, mean a
ge 11.0 years) were evaluated at baseline Cat diagnosis) and after 3 and 6
mo of disease. Eighteen patients were reevaluated 24 mo later. The assessme
nt included physical and cardiac examination, electrocardiogram, chest radi
ography, and color ECHO/Doppler performed blindly by different investigator
s. The control group included 15 healthy children.
Results. We observed clinical carditis in 8 patients (36.4%): Group 1, all
with ECHO abnormalities. We observed no clinical cardiac manifestations in
14 patients (Group 2), but 5 (35.7%) had positive ECHO/Doppler abnormalitie
s that persisted at least 6 mo in followup assessments. Mitral and aortic w
ere the most frequently involved valves. In Group 1 we observed normalizati
on of the ECHO/Dappler in 3 patients, improvement in 2, no change in 2, and
worsening in one. Twelve of 14 patients without clinical carditis were ree
valuated, including the 5 patients with ECHO/Doppler abnormalities during t
he initial evaluations; normalization or improvement: was observed in 2 pat
ients, no change in 2, and worsening in one, We observed no ECHO/Doppler ab
normalities in the control group.
Conclusion. This blind prospective study suggests the existence of asymptom
atic carditis in some patients with rheumatic fever and the role ECHO/Doppl
er investigation could play in diagnosis and Followup.