Role of echocardiography in detection of subclinical valvulitis in patients with rheumatic fever

Abstract EN

Background: Echocardiography has been used as an important tool in the detection of subclinical valvulitis thus allowing early diagnosis, treatment and prophylaxis, limiting recurrence and progress into severe form of rheumatic heart disease (RHD).

Objective: This study aims to evaluate the role of echocardiography in early detection of subclinical valvulitis in patients with rheumatic fever with no clinical evidence of RHD.

Methodology: This is a cross sectional study where patients coming to"Rheumatic Fever" clinic in Cairo University Hospitals were examined and those with arthritis and chorea without clinical evidence of carditis and with absence of murmurs were subjected to 2D Doppler echocardiography to detect subclinical valve affection according to WHO echocardiographic criteria during the period from the beginning of September 2011 to the end of December 2012.

Results: A total of 1096 patients with different presentations were examined and 50 patients fulfilled the study inclusion and exclusion criteria where 26 patients (more in females 16 versus.

10 males) representing 52% had subclinical valvulitis by 2 D Doppler Echocardiography.

The majority of cases presented with acute arthritis (44 patients representing 88% of study population) , of those 21 patients representing 42% of total study population and 48% of patients with arthritis had subclinical valvulitis.

In the other hand 6 patients presented with chorea constituting 12% of total patients studied while 5 representing 10% of total patients and 83.3% of patients with chorea proved to have subclinical valve affection.

Mitral valve was more affected than aortic valve where 14 patients representing 54% of patients with subclinical valvulitis had mitral regurge only versus 5 patients representing 19% of patients with subclinical valvulitis having aortic regurge only whereas 7 patients representing 27% of patients with subclinical valvulitis had both mitral and aortic valve affection.

Conclusion: Echocardiography should be performed in patients with arthritis or chorea with no clinical carditis.