Clinical Profile of Rheumatic Fever and Rheumatic Heart Disease in Children Under 15 Years Age Group and Its Correlation With Echocardiography

Abstract

Context (Back ground) Acute Rheumatic fever and Rheumatic heart disease are the most common acquired childhood heart disease in India. It is well established that 2 D Echo cardiography is more sensitive in picking up minor degrees of valvular regurgitation than clinical examination. AIMS & OBJECTIVES:To study the clinical profile of "Rheumatic Fever and Rheumatic heart disease" & correlate it with Echocardiographic findings in Children under 15 years age group presenting to a tertiary care hospital. MATERIALS AND METHODS OF STUDY: Thirty six cases of Acute Rheumatic fever, which includes eight cases of first attack and twenty eight cases of reactivation of Rheumatic fever were studied over a period of two years in paediatric medical wards, King George Hospital, Visakhapatnam. The revised (1992) modified Jones criteria with the 1988 WHO modification was taken as a criterion to diagnose Acute Rheumatic fever. RESULTS: Peak age of Acute Rheumatic fever and Chronic Rheumatic heart disease is between 5-10 years (55.8%). No sex variation has been observed. Fever and joint involvement are the most common clinical manifestations (87.5%each) in first attack cases. Active carditis (75%) the second most common manifestation, followed by arthralgia (25%) and sore throat (25%), chorea, chest pain, abdominal pain were infrequent manifestations found to be 12.5% each. None of the cases had Erythema marginatum. CONCLUSION: In the present study the clinical findings were correlated with that of previous studies and Echocardiographic findings were correlated well as far as moderate to severe lesions. Further Echocardiography was proved to be more sensitive in detecting even trivial or mild aortic regurgitation and mitral or aortic stenosis.