Problems of chronic rheumatic heart disease diagnosis at the present stage

Abstract

The review refl ects modern data on the epidemiology of acute rheumatic fever and chronic rheumatic heart disease in Russia and the world at present, as well as the dynamics of the prevalence of these diseases over the past decades. Much attention is paid to the issues of modern diagnostics of these conditions by physical, laboratory and instrumental methods. The focus is on the Jones criteria in the diagnosis of acute rheumatic fever in accordance with their revision by the American Heart Association experts in 2015. Taking into account the fact that damage to the valvular apparatus of the heart in acute rheumatic fever is the main disabling outcome of carditis at the present stage, a special place in the article is devoted to the discussion of echocardiographic criteria for valvulitis. The recommendations of the International Expert Council of the World Heart Federation aimed at detecting chronic rheumatic heart disease in patients without a history of acute rheumatic fever diagnosed by ultrasound imaging are also given. Criteria for pathological aortic and mitral regurgitation are presented. The authors believe that extrapolation of modern principles of ultrasound diagnostics of chronic rheumatic heart disease in Russia and their use as screening programs in young people and adolescents will contribute to its early detection and timely selection of patients for secondary prevention of benzathine with benzylpenicillin.