title: Heart lesion after the first attack of the rheumatic Fever 22 years experience in single centre.
abstract: BACKGROUND
  Acute rheumatic fever and its sequels, rheumatic heart diseases, remain major unsolved preventable health problems in Kosovo population, particularly among the disadvantages indigenous Albanian and Egyptians people. In Kosovo, despite of performing secondary prophylaxis with benzathine penicillin, acute rheumatic fever hospitalization rates have remained essentially unchanged for the last 20 years. The role of echocardiography in the diagnosis of acute rheumatic carditis was established over the last 20 years.
  
  
  OBJECTIVE
  In this study we aimed to determine the prevalence of rheumatic heart disease in children from Kosovo population with first attack of acute rheumatic fever. Also, we presented that echocardiography examination detects a greater prevalence of rheumatic heart disease than other diagnostic procedures. We aimed to compare the sensitivity and specificity of cardiac auscultation, ECG record, lab analysis to echocardiography and to determine the feasibility of specific age in this setting.
  
  
  METHODS
  To optimize accurate diagnosis of rheumatic fever and rheumatic heart disease, we utilized two group models. In the first group of 388 children, hospitalized and treated before 1999, diagnosis of rheumatic fever was decided basing on the clinical and laboratory findings whereas in second group (221 children treated from1999 to 2010) clinical and lab diagnosis were amplified also on the detection by echocardiography.
  
  
  CONCLUSIONS
  In second group, using echocardiography as a method of diagnosis and assessment children with rheumatic fever, we found high rates of undetected rheumatic heart disease in this high-risk group population. Echocardiographic examination of children with rheumatic fever for rheumatic heart disease may over diagnose rheumatic heart disease unless congenital mitral valve anomalies and physiological regurgitation are excluded.
authors: Pediatric Clinic, University Clinical Center of Kosovo, Prishitna, Republic of Kosovo.
authors: Ramush A
authors: RA
authors: Bejiqi
authors: Pediatric Clinic, University Clinical Center of Kosovo, Prishitna, Republic of Kosovo.
authors: Ragip
authors: R
authors: Retkoceri
authors: Pediatric Clinic, University Clinical Center of Kosovo, Prishitna, Republic of Kosovo.
authors: Naim
authors: N
authors: Zeka
authors: Main Center of Family Medicine, Prishtina, Republic of Kosovo.
authors: Hana
authors: H
authors: Bejiqi
authors: Main Center of Family Medicine, Prishtina, Republic of Kosovo.
authors: Arber
authors: A
authors: Retkoceri
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods*; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D063826:Kosovo / Q000453:epidemiology; D008297:Male; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology*; D010401:Penicillin G Benzathine / Q000627:therapeutic use*; D012213:Rheumatic Fever / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology / Q000266:history; D012680:Sensitivity and Specificity
chemical_list: D000900:Anti-Bacterial Agents; D010401:Penicillin G Benzathine
keywords: chorea minor; echocardiography; rheumatic fever; rheumatic heart disease