Cardiac symptoms associated with rheumatic fever in children who visited Damascus Hospital between 2013 and 2020

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Abstract

Background In addition to assessing the clinical results and prognosis of patients with acute rheumatic fever treated in the Cardiology Clinic at Damascus Hospital, this study intends to ascertain the clinical usefulness of echocardiography (ECHO) in the diagnosis of acute rheumatic fever. Methods and materials: A retrospective analysis was conducted on 160 ARF (6–17) patients, with a mean age of 11.7 ± 2.3 years, 88/72 female and male diagnoses based on Jones criteria, who were monitored in the cardiology clinic at Damascus Hospital from October 2013 to December 2020. Results Of the 104 patients diagnosed with rheumatic heart disease (RHD), approximately 29.4% had subclinical carditis; in contrast, clinical carditis was frequently associated with chorea (39%) and polyarthritis (37.1%). Sixty-six percent of patients with rheumatic fever were found to be between the ages of 10 and 13; thirty-three percent (n = 50) reported having frequent arthralgia during the winter, and the most common associated symptoms were carditis + arthritis (35%) and carditis + chorea (19.4%). When it came to carditis sufferers, it was The aortic (50.6%) and mitral (63.8%) valves were the most commonly impacted, respectively. In cases diagnosed during and after 2015, the prevalence of subclinical carditis, arthralgia, and uniarthritis rose and 71 out of 104 individuals saw an improvement in their valvular heart disease result. Individuals with carditis (68.2%) Patients with clinical carditis and those who followed prophylactic treatment had a significantly higher rate of regression of heart valve symptoms over the course of around 7 years of follow-up compared to patients with subclinical carditis and those who did not follow prophylactic treatment. Conclusion We conclude that early prophylaxis can reduce the prevalence of adult RHD and complications, subclinical carditis is associated with the risk of permanent RHD, and nonadherence to secondary prophylaxis is significantly associated with recurrent ARF. Additionally, ECHO findings should be included in the diagnostic criteria for ARF. potential connected to it.

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