What is the True Frequency of Carditis in Acute Rheumatic Fever? A Prospective Clinical and Doppler Blind Study of 56 Children with up to 60 Months of Follow-Up Evaluation

What is the True Frequency of Carditis in Acute Rheumatic Fever? A Prospective Clinical and Doppler Blind Study of 56 Children with up to 60 Months of Follow-Up Evaluation

Autor Caldas, Alvaro Manuel Autor UNIFESP Google Scholar
Ramos Ascensao Terreri, Maria Teresa Autor UNIFESP Google Scholar
Moises, Valdir Ambrosio Autor UNIFESP Google Scholar
Camelo Silva, Celia Maria Autor UNIFESP Google Scholar
Len, Claudio Arnaldo Autor UNIFESP Google Scholar
Carvalho, Antonio Carlos Autor UNIFESP Google Scholar
Esteves Hilario, Maria Odete Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Background This study aimed to evaluate prospectively clinical and echocardiographic findings of patients who had rheumatic fever with and without clinical features of cardiac involvement. Methods for this study, 56 consecutive patients (mean age, 11.4 years) with acute rheumatic fever diagnosed according to the 1992 modified Jones criteria were evaluated at diagnosis, after 3 and 6 months, then at 2 and 5 years. All assessments were performed blindly and included physical and cardiac examination, electrocardiogram, chest X-ray, and two-dimensional color-flow Doppler echocardiography. Results Initial clinical carditis was observed for 27 patients (48.2%), all of whom had positive echocardiographic abnormalities. Echocardiographic abnormalities were observed in 11 patients who had arthritis or chorea presentation without initial clinical carditis. Persistence of the abnormalities was observed at a late follow-up evaluation in 72.7% of the cases. Sydenham's chorea was present in 8 patients with clinical carditis and in 10 without this disorder, 8 of whom had echocardiographic abnormalities. Conclusion Patients who had acute rheumatic fever without clinical signs of carditis showed acute and late follow-up echocardiographic abnormalities suggestive of cardiac involvement. Clinicians should be attentive for the presence of cardiac involvement among patients with chorea.
Palavra-chave Echocardiography
Jones criteria
Rheumatic fever
Subclinical carditis
Sydenham' chorea
Idioma Inglês
Data de publicação 2008-11-01
Publicado em Pediatric Cardiology. New York: Springer, v. 29, n. 6, p. 1048-1053, 2008.
ISSN 0172-0643 (Sherpa/Romeo, fator de impacto)
Publicador Springer
Extensão 1048-1053
Fonte http://dx.doi.org/10.1007/s00246-008-9242-z
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000261069500005
Endereço permanente http://repositorio.unifesp.br/handle/11600/30989

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