Role of colour flow doppler echocardiography in the identification of acute rheumatic carditis in children without clinical evidence of carditis

This study was carried out on 70 patients: 15 patients with presumptive diagnosis of acute rheumatic fever [group one], 25 patients with no clinical evidence of carditis [group two] and 30 patients with a clinical evidence of carditis [group three] in addition to 20 healthy children as control group A and another 20 normal children [control group B] formed a comparison group for 14 patients of group two. The results revealed that mitral valve thickening was detected in group three [100%], but only in 28% of group two and 20% of group one. All patients had normal left ventricular systolic function. Congestive heart failure was invariably associated with the presence of hemodynamically significant valve lesions. The specificity of Doppler for detecting pathologic mitral regurgitation was 100% with a positive predictive value of 100%. A pathologic mitral regurgitation was identified in 100% of group three versus 48% in group two and 33.5% in group one and it was evident in seven patients with echocardiographically normal appearance of valve morphology