Cardiac sequelae of patients with rheumatic fever during a five-year follow-up in Srinagarind hospital of Khon Kaen University(Thai)

Abstract

The natural history of valvular regurgitation detected by echocardiography in acute rheumatic fever has been lacking. Clinical assessment and transthoracic color Doppler echocardiography were performed for each patient with an initial attack of acute rheumatic fever (Khon Kaen University, Thailand; 1992-2003) at the time of their presentation. Clinical examinations and echocardiography were done for each at five-year follow-up. Of 110 patients, 75 (68%) had carditis (valvulitis) evident by auscultation at the time of the initial attack. Seven (20%) of the 35 patients with no clinical evidence of carditis had echocardiographic evidence of acute valvular regurgitation (subclinical valvulitis). All 75 patients with carditis had echocardiographic evidence of acute mitral regurgitation. Of the 75 patients with carditis regularly followed, the persistence of a heart murmur and significant valvular regurgitation by echocardiography were 39% (29/75) and 51% (38/75) at five-year follow-up. This suggests that an echocardiographic examination in the patients with initial attack of acute rheumatic fever has more benefit than the usual auscultatory method in the early diagnosis of rheumatic carditis (valvulitis) and also beneficial is at five-year followup of rheumatic valvular heart disease.