title: Rheumatic silent carditis: echocardiographic diagnosis and prognosis of long-term follow up.
abstract: BACKGROUND
  Rheumatic fever and rheumatic heart disease continue to be an important public health problem in developing countries. Doppler echocardiography is now widely used for early detection and recurrence of clinical evident carditis (CC) and silent (subclinical) carditis (SC). The aim of this study was to determine the frequency of SC and to compare clinical and echocardiographic features of CC and SC.
  
  
  METHODS
  A total of 156 consecutive patients diagnosed with acute rheumatic fever were included in the study. The patients without clinical evidence but with echocardiographic findings of carditis were diagnosed as having SC.
  
  
  RESULTS
  Acute rheumatic fever was diagnosed in 156 patients, and 103 of these (66%) had carditis. The prevalence of SC was 28.2% among these 103 patients. Seventy-four of the patients with carditis were followed up for >1 year, and 20 of those had SC. Valvular regurgitation disappeared completely in 18.5% and improved in 45.5% of the CC patients. The recovery and improvement rates in the SC group were 15% and 30%, respectively.
  
  
  CONCLUSIONS
  It is suggested that Doppler echocardiography be performed in all patients with suspected acute rheumatic fever for early detection of SC. Echocardiography should be used as a diagnostic criterion in order not to miss a diagnosis of SC.
authors.affiliation: Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Pekpak
authors.forename: Semra
authors.initials: S
authors.lastname: Atalay
authors.forename: Cem
authors.initials: C
authors.lastname: Karadeniz
authors.forename: Fikri
authors.initials: F
authors.lastname: Demir
authors.forename: Ercan
authors.initials: E
authors.lastname: Tutar
authors.forename: Tayfun
authors.initials: T
authors.lastname: Uçar
mesh_terms: D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000000981:diagnostic imaging*; D011379:Prognosis; D012214:Rheumatic Heart Disease / Q000000981:diagnostic imaging*; D013997:Time Factors; D014463:Ultrasonography
keywords: carditis; echocardiography; rheumatic fever; rheumatic heart disease