Abstract
Purpose: Rheumatic Heart Disease (RHD) is estimated to affect over 20 million people worldwide, the vast majority being children in developing countries. Conventionally, auscultation has been used for diagnosing RHD, but echo-Doppler is likely to be more sensitive and specific. We carried out a cross sectional survey to diagnose RHD in asymptomatic children aged 5-15 years, living in rural areas, using portable echocardiography.
Methods: Children, aged 5-15 years, from government schools and private schools, in a pre identified rural area were studied. After a history and physical examination, echo-Doppler was performed, using a bedside portable echocardiography machine. A diagnosis of RHD was made by echo-Doppler using WHO criteria.
Results: A total of 2600 children were screened. 1314 were males. The mean age was 11.18 ± 2.4 years. All children were asymptomatic. RHD was diagnosed by clinical examination in two cases only (clinical prevalence: 0.07%). Echo-Doppler diagnosed RHD in 65 cases, giving a prevalence of 2.5%. Doppler revealed mitral regurgitation in 56 and aortic regurgitation in nine. Thickening of the valve was present in all 65 cases. Other cardiac lesions identified by echo-Doppler were moderate sized atrial septal defect (four), bicuspid aortic valve (four), ventricular septal defect large (two), tetralogy of Fallot (two), patent ductus arteriosus (three) and mild left ventricular dysfunction, possibly due to dilated cardiomyopathy (one).
Conclusions: This preliminary work demonstrates feasibility of echo screening in children for diagnosing RHD. In this study, the prevalence of RHD was found to be high, when screening echo-Doppler was used.
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Saxena, A., Ramakrishnan, S., Roy, A. et al. 218 Early Results of the Rheumatic (Rheumatic Heart Echo Utilization and Monitoring Actuarial Trends in Indian Children) Study. Pediatr Res 68 (Suppl 1), 114 (2010). https://doi.org/10.1203/00006450-201011001-00218
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DOI: https://doi.org/10.1203/00006450-201011001-00218