Doppler echocardiography distinguishes between physiologic and pathologic 'silent' mitral regurgitation in patients with rheumatic fever
| Autor: | L. G. Veasy, L. LuAnn Minich, Lloyd Y. Tani, Luciana T. Pagotto, Robert E. Shaddy |
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| Rok vydání: | 1997 |
| Předmět: |
medicine.medical_specialty
Duplex ultrasonography Adolescent Clinical Investigations Regurgitation (circulation) Doppler echocardiography Chest pain Asymptomatic Sensitivity and Specificity Diagnosis Differential Recurrence Mitral valve Internal medicine medicine Humans cardiovascular diseases Prospective Studies Child Observer Variation Mitral regurgitation medicine.diagnostic_test business.industry Rheumatic Heart Disease Mitral Valve Insufficiency General Medicine medicine.disease Echocardiography Doppler Myocarditis medicine.anatomical_structure Child Preschool Acute Disease Cardiology cardiovascular system Rheumatic fever medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Clinical cardiology. 20(11) |
| ISSN: | 0160-9289 |
| Popis: | Background: The diagnosis of rheumatic fever is based on physical findings (major) and supporting laboratory evidence (minor) as defined by the Jones criteria. Rheumatic carditis is characterized by auscultation of a mitral regurgitant murmur. Doppler echocardiography, however, may detect mitral regurgitation when there is no murmur (“silent” mitral regurgitation), even in normal individuals. Hypothesis: The hypothesis of this study was that physiologic mitral regurgitation can be differentiated from pathologic “silent” mitral regurgitation by Doppler echocardiography. Methods: The study group consisted of 68 patients (2–27 years) with normal two-dimensional imaging and Doppler evidence of mitral regurgitation but no murmur. Patients with rheumatic fever (n = 37) met Jones criteria (chorea in 20, arthritis in 17). Patients without rheumatic fever (n = 31) were referred for innocent murmur (n = 7), abnormal electrocardiogram (n = 13), and chest pain (n = 11). Echoes were independently reviewed by two cardiologists blinded to the diagnosis. Pathologic mitral regurgitation was defined as meeting the following four criteria: (1) length of color jet > 1 cm, (2) color jet identified in at least two planes, (3) mosaic color jet, and (4) persistence of the jet throughout systole. Jet orientation was also noted. Results: Using the above criteria, there was agreement in echo interpretation of pathologic versus physiologic mitral regurgitation in 67 of 68 patients (interobserver variability of 1.5%). Pathologic regurgitation was found in 25 (68%) patients with rheumatic fever but in only 2 (6.5%) patients without rheumatic fever (p |
| Databáze: | OpenAIRE |
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