ABSTRACT
In this article the authors describe a clinical case of acute rheumatic fever (according to revised Jones criteria, American Heart Association [AHA], 1992) with cardiac tamponade, emphasizing this uncommon presentation. An adolescent patient with a clinical picture of cardiac tamponade was seen in the emergency department. Clinical progression and tests demonstrated rheumatic carditis with an initial manifestation of pericarditis with cardiac tamponade. This report aims to warn physicians about the diagnosis of rheumatic carditis in an unusual clinical presentation, in cases of cardiac tamponade, particularly in school-aged children and adolescents in countries with a high prevalence of rheumatic fever. The literature contains only two documented cases of cardiac tamponade related to acute rheumatic fever, and this case represents a third.
Subject(s)
Cardiac Tamponade/etiology , Rheumatic Fever/complications , Rheumatic Heart Disease/complications , Anti-Bacterial Agents/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Antihypertensive Agents/therapeutic use , Captopril/therapeutic use , Cardiac Tamponade/diagnosis , Cardiac Tamponade/drug therapy , Child , Disease Progression , Diuretics/therapeutic use , Female , Furosemide/therapeutic use , Gentamicins/therapeutic use , Humans , Oxacillin/therapeutic use , Penicillin G Benzathine/therapeutic use , Pericardiocentesis , Prednisone/therapeutic use , Protein Synthesis Inhibitors/therapeutic use , Rheumatic Fever/diagnosis , Rheumatic Fever/drug therapy , Rheumatic Heart Disease/diagnosis , Rheumatic Heart Disease/drug therapyABSTRACT
PURPOSE: To determine the prevalence of rheumatic fever (RF) among children of a public high school in Belo Horizonte, Brazil. METHODS: The study was performed from March to December/92, and involved high school students coming from families of the medium and low-medium social classes. Considering the total of 1,400 students registered in a public school and the estimated RF prevalence in the developing country, 729 students were randomly chosen to be interviewed and examined by a researcher. The children suspected of being affect by RF were submitted to echocardiography in order to find any cardiac lesions. RESULTS: Due to several different factors, only 550 students aging from 10 to 20 years were admitted in this study. Four children, previously under secondary prophylactics, had already had the diagnosis of RF. Among these children, only one had heart disease (combined mitral incompetence and stenosis, and aortic incompetence). From the other three children, only one had the diagnosis of RF confirmed according to the Jones criteria. CONCLUSION: From the ata obtained, the prevalence of RF was calculated in 3.6/1000.
