DOPPLER-ECHOCARDIOGRAPHY AND THE EARLY DIAGNOSIS OF CARDITIS IN ACUTE RHEUMATIC-FEVER

被引:52
作者
ABERNETHY, M
BASS, N
SHARPE, N
GRANT, C
NEUTZE, J
CLARKSON, P
GREAVES, S
LENNON, D
SNOW, S
WHALLEY, G
机构
[1] UNIV AUCKLAND,SCH MED,DEPT MED,AUCKLAND 1,NEW ZEALAND
[2] AUCKLAND HOSP,DEPT CARDIOL,AUCKLAND,NEW ZEALAND
[3] UNIV AUCKLAND,SCH MED,DEPT PAEDIAT,AUCKLAND 1,NEW ZEALAND
[4] GREEN LANE HOSP,DEPT CARDIOL,AUCKLAND 3,NEW ZEALAND
来源
AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE | 1994年 / 24卷 / 05期
关键词
ACUTE RHEUMATIC FEVER; DOPPLER ECHOCARDIOGRAPHY;
D O I
10.1111/j.1445-5994.1994.tb01753.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The incidence of acute rheumatic fever in New Zealand remains relatively high. Reliable early diagnosis of carditis is difficult and important in management. Aim: To determine if Doppler echocardiography contributed to the early diagnosis of carditis in acute rheumatic fever. Methods: Forty-seven patients admitted to hospital with suspected acute rheumatic fever and 19 control patients, with a febrile illness due to a documented non-cardiac bacterial infection, were assessed two days and two weeks following admission. Presence or absence of clinical carditis was determined by a cardiologist unaware of the suspected diagnosis, from clinical examination, chest radiograph, electrocardiogram (ECG) and two dimensional echocardiogram. Doppler echocardiography was then performed and interpreted by a second cardiologist unaware of the diagnosis. After completion of the study the Jones criteria were applied, to categorise the patients with suspected acute rheumatic fever into four groups for the final diagnosis: no acute rheumatic fever, possible acute rheumatic fever, definite acute rheumatic fever without carditis, and definite acute rheumatic fever with carditis. Results: In 19 patients with a final diagnosis of acute rheumatic fever and carditis at the baseline assessment carditis was detected by clinical assessment in 15 patients, compared with 19 patients with evidence of significant valve regurgitation by Doppler echocardiography. Following the two week assessment, all 19 patients had both clinical and Doppler evidence of carditis. Five patients with a final clinical diagnosis of possible acute rheumatic fever or definite acute rheumatic fever without carditis, had a Doppler abnormality detected. There was no clinical or Doppler abnormality in the febrile controls. Conclusions: Doppler echocardiography is more sensitive than clinical assessment in the detection of carditis in acute rheumatic fever, and can contribute to earlier diagnosis.
引用
收藏
页码:530 / 535
页数:6
相关论文
共 19 条
[1]   AGE-RELATED VALVULAR REGURGITATION - A STUDY BY PULSED DOPPLER ECHOCARDIOGRAPHY [J].
AKASAKA, T ;
YOSHIKAWA, J ;
YOSHIDA, K ;
OKUMACHI, F ;
KOIZUMI, K ;
SHIRATORI, K ;
TAKAO, S ;
SHAKUDO, M ;
KATO, H .
CIRCULATION, 1987, 76 (02) :262-265
[2]  
[Anonymous], 1984, CIRCULATION, V69, p204A
[3]  
[Anonymous], 1965, CIRCULATION, V32, P457
[4]   PULSED AND CONTINUOUS WAVE DOPPLER ECHOCARDIOGRAPHIC ASSESSMENT OF VALVULAR REGURGITATION IN NORMAL SUBJECTS [J].
BERGER, M ;
HECHT, SR ;
VANTOSH, A ;
LINGAM, U .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1989, 13 (07) :1540-1545
[5]   PREVALENCE OF VALVULAR REGURGITATION BY DOPPLER ECHOCARDIOGRAPHY IN PATIENTS WITH STRUCTURALLY NORMAL HEARTS BY TWO-DIMENSIONAL ECHOCARDIOGRAPHY [J].
CHOONG, CY ;
ABASCAL, VM ;
WEYMAN, J ;
LEVINE, RA ;
GENTILE, F ;
THOMAS, JD ;
WEYMAN, AE .
AMERICAN HEART JOURNAL, 1989, 117 (03) :636-642
[6]  
FOLGER GM, 1992, BRIT HEART J, V67, P434
[7]   DOPPLER ECHOCARDIOGRAPHIC FINDINGS OF MITRAL AND AORTIC VALVULAR REGURGITATION IN CHILDREN MANIFESTING ONLY RHEUMATIC ARTHRITIS [J].
FOLGER, GM ;
HAJAR, R .
AMERICAN JOURNAL OF CARDIOLOGY, 1989, 63 (17) :1278-1280
[8]   The dianosis of rheumatic fever [J].
Jones, TD .
JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1944, 126 :481-484
[9]   PULSED DOPPLER REGURGITANT FLOW PATTERNS OF NORMAL VALVES [J].
KOSTUCKI, W ;
VANDENBOSSCHE, JL ;
FRIART, A ;
ENGLERT, M .
AMERICAN JOURNAL OF CARDIOLOGY, 1986, 58 (03) :309-313
[10]  
LENNON D, 1988, NEW ZEAL MED J, V101, P396