Rheumatic fever echocardiography or ultrasound: Difference between revisions

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__NOTOC__
__NOTOC__
{{Rheumatic fever}}
{{Rheumatic fever}}
{{CMG}}; {{AOEIC}} {{VK}}
{{CMG}}; {{AE}} {{VK}}; {{AG}}


==Overview==
==Overview==
Echocardiography may be helpful in establishing carditis and in monitoring the progress of valve defect.
Echocardiography may be helpful in establishing the diagnosis of [[carditis]] and monitoring the progress of valve defect present in rheumatic fever.  


==Echocardiography==
==Echocardiography==
Echocardiography helps in establishing the diagnosis of [[carditis]]. Valvular involvement resulting in stenosis or regurgitation of mitral valve and/or aortic valve can be detected by echocardiogram more accurately than by cardiac auscultation along with quantifying the degree of insufficiency and ventricular dysfunction. Studies relying on echocardiography in the diagnosis of rheumatic heart disease have demonstrated that the rates of subclinical carditis is up to 10 times higher than that diagnosed clinical examination<ref name="pmid17671255">{{cite journal| author=Marijon E, Ou P, Celermajer DS, Ferreira B, Mocumbi AO, Jani D et al.| title=Prevalence of rheumatic heart disease detected by echocardiographic screening. | journal=N Engl J Med | year= 2007 | volume= 357 | issue= 5 | pages= 470-6 | pmid=17671255 | doi=10.1056/NEJMoa065085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17671255  }} </ref><ref name="pmid20345448">{{cite journal| author=Bhaya M, Panwar S, Beniwal R, Panwar RB| title=High prevalence of rheumatic heart disease detected by echocardiography in school children. | journal=Echocardiography | year= 2010 | volume= 27 | issue= 4 | pages= 448-53 | pmid=20345448 | doi=10.1111/j.1540-8175.2009.01055.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20345448  }} </ref><ref name="pmid18952636">{{cite journal| author=Sadiq M, Islam K, Abid R, Latif F, Rehman AU, Waheed A et al.| title=Prevalence of rheumatic heart disease in school children of urban Lahore. | journal=Heart | year= 2009 | volume= 95 | issue= 5 | pages= 353-7 | pmid=18952636 | doi=10.1136/hrt.2008.143982 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18952636  }} </ref><ref name="pmid18398402">{{cite journal| author=Carapetis JR, Hardy M, Fakakovikaetau T, Taib R, Wilkinson L, Penny DJ et al.| title=Evaluation of a screening protocol using auscultation and portable echocardiography to detect asymptomatic rheumatic heart disease in Tongan schoolchildren. | journal=Nat Clin Pract Cardiovasc Med | year= 2008 | volume= 5 | issue= 7 | pages= 411-7 | pmid=18398402 | doi=10.1038/ncpcardio1185 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18398402  }} </ref>
Echocardiography may be helpful in establishing the diagnosis of [[carditis]]. Valvular involvement resulting in [[stenosis]] or [[regurgitation (circulation)|regurgitation]] of [[mitral valve]] or [[aortic valve]] can be detected by echocardiogram more accurately than [[cardiac auscultation]] along with quantifying the degree of insufficiency and [[ventricular dysfunction]].<ref name="pmid17671255">{{cite journal| author=Marijon E, Ou P, Celermajer DS, Ferreira B, Mocumbi AO, Jani D et al.| title=Prevalence of rheumatic heart disease detected by echocardiographic screening. | journal=N Engl J Med | year= 2007 | volume= 357 | issue= 5 | pages= 470-6 | pmid=17671255 | doi=10.1056/NEJMoa065085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17671255  }} </ref><ref name="pmid20345448">{{cite journal| author=Bhaya M, Panwar S, Beniwal R, Panwar RB| title=High prevalence of rheumatic heart disease detected by echocardiography in school children. | journal=Echocardiography | year= 2010 | volume= 27 | issue= 4 | pages= 448-53 | pmid=20345448 | doi=10.1111/j.1540-8175.2009.01055.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20345448  }} </ref><ref name="pmid18952636">{{cite journal| author=Sadiq M, Islam K, Abid R, Latif F, Rehman AU, Waheed A et al.| title=Prevalence of rheumatic heart disease in school children of urban Lahore. | journal=Heart | year= 2009 | volume= 95 | issue= 5 | pages= 353-7 | pmid=18952636 | doi=10.1136/hrt.2008.143982 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18952636  }} </ref><ref name="pmid18398402">{{cite journal| author=Carapetis JR, Hardy M, Fakakovikaetau T, Taib R, Wilkinson L, Penny DJ et al.| title=Evaluation of a screening protocol using auscultation and portable echocardiography to detect asymptomatic rheumatic heart disease in Tongan schoolchildren. | journal=Nat Clin Pract Cardiovasc Med | year= 2008 | volume= 5 | issue= 7 | pages= 411-7 | pmid=18398402 | doi=10.1038/ncpcardio1185 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18398402  }} </ref> [[Mitral regurgitation]] can result in [[left atrial enlargement]]. In patients with chronic rheumatic heart disease, echocardiogram helps in tracking the progression of valve stenosis and may help in determining the time for surgical intervention. Increased echodensity of the mitral valve may signify [[calcification]].


To diagnose [[mitral valve prolapse]], the following criteria should be fulfilled - Movement of any part of either leaflet more than 2mm behind the annular plane in parasternal long axis view and movement of point of co-aptation behind the annular plane in apical 4 chamber view. [[Mitral regurgitation]] can result in [[left atrial enlargement]].
To diagnose [[mitral valve prolapse]], the following criteria should be fulfilled:
 
*Movement of any part of either leaflet more than 2mm behind the annular plane in parasternal long axis view
In patients with chronic rheumatic heart disease, echocardiogram helps in tracking the progression of valve stenosis and thus may help in determining the time for surgical intervention. Increased echodensity of the mitral valve may signify calcification.
*Movement of point of co-aptation behind the annular plane in apical 4 chamber view


[[File:Mitralinsuff TEE.jpg|thumb|left|400px|Transesophageal echocardiogram showing [[Mitral valve prolapse]]]]
[[File:Mitralinsuff TEE.jpg|thumb|left|400px|Transesophageal echocardiogram showing [[Mitral valve prolapse]]]]
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}





Revision as of 18:30, 19 October 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S. [2]; Anthony Gallo, B.S. [3]

Overview

Echocardiography may be helpful in establishing the diagnosis of carditis and monitoring the progress of valve defect present in rheumatic fever.

Echocardiography

Echocardiography may be helpful in establishing the diagnosis of carditis. Valvular involvement resulting in stenosis or regurgitation of mitral valve or aortic valve can be detected by echocardiogram more accurately than cardiac auscultation along with quantifying the degree of insufficiency and ventricular dysfunction.[1][2][3][4] Mitral regurgitation can result in left atrial enlargement. In patients with chronic rheumatic heart disease, echocardiogram helps in tracking the progression of valve stenosis and may help in determining the time for surgical intervention. Increased echodensity of the mitral valve may signify calcification.

To diagnose mitral valve prolapse, the following criteria should be fulfilled:

  • Movement of any part of either leaflet more than 2mm behind the annular plane in parasternal long axis view
  • Movement of point of co-aptation behind the annular plane in apical 4 chamber view
Transesophageal echocardiogram showing Mitral valve prolapse


References

  1. Marijon E, Ou P, Celermajer DS, Ferreira B, Mocumbi AO, Jani D; et al. (2007). "Prevalence of rheumatic heart disease detected by echocardiographic screening". N Engl J Med. 357 (5): 470–6. doi:10.1056/NEJMoa065085. PMID 17671255.
  2. Bhaya M, Panwar S, Beniwal R, Panwar RB (2010). "High prevalence of rheumatic heart disease detected by echocardiography in school children". Echocardiography. 27 (4): 448–53. doi:10.1111/j.1540-8175.2009.01055.x. PMID 20345448.
  3. Sadiq M, Islam K, Abid R, Latif F, Rehman AU, Waheed A; et al. (2009). "Prevalence of rheumatic heart disease in school children of urban Lahore". Heart. 95 (5): 353–7. doi:10.1136/hrt.2008.143982. PMID 18952636.
  4. Carapetis JR, Hardy M, Fakakovikaetau T, Taib R, Wilkinson L, Penny DJ; et al. (2008). "Evaluation of a screening protocol using auscultation and portable echocardiography to detect asymptomatic rheumatic heart disease in Tongan schoolchildren". Nat Clin Pract Cardiovasc Med. 5 (7): 411–7. doi:10.1038/ncpcardio1185. PMID 18398402.

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