Echocardiographic screening for rheumatic heart disease

Echocardiographic screening for rheumatic heart disease

• 1.
  Echocardiographic Screening for Rheumatic Heart Disease WorldHeart Federation Criteria for the Echocardiographic Diagnosis of RHD in Individuals Aged ≤20 Years
• 2.
  Clinical Perspective  RHDaffects ≈20 million people worldwide  highest in developing countries  significant morbidity and mortality  Subclinical detection adds to of secondary prophylaxis  echocardiographic definitions evolving  In 2012, the WHF published evidence-based  guidelines for the echocardiographic diagnosis of RHD  but these criteria have not yet been applied
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  Effective evaluation Echocardiography searchClinical search 90% RHD detection 10% of detection
• 4.
  Definite echocardiographic Criteriafor RHD  A) Pathologic MR and at least 2 morphologic features of RHD of the MV  B) MS mean gradient ≥4 mm Hg  C) Pathological AR and at least 2 morphological features of RHD of the AV  D) Borderline disease of both the AV and MV
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  Keywords  Definite RHD Pathological MS  Pathological MR  Pathological AR  Borderline RHD  Morphological RHD
• 6.
  Borderline RHD (A,B, or C)  A) At least 2 morphologic features of RHD of the MV without pathologic MR or MS  B) Pathologic MR  C) Pathologic AR
• 7.
  Echocardiographic criteria forpathologic regurgitation (all 4 Doppler criteria must be met) Pathological MR Pathological AR 1. Seen in 2 views 2. In at least 1 view jet length ≥2 cm 3. Peak velocity ≥3 m/s for 1 complete Envelope in systole 4. Pansystolic jet in at least 1 envelope Seen in 2 views 2. In at least 1 view jet length ≥1 cm 3. Peak velocity ≥3 m/s for 1 complete Envelope in diastole 4. Pandiastolic jet in at least 1 envelope
• 8.
  Morphologic features ofRHD Features in the MV Features in the AV 1. AMVL thickening ≥3 mm 2. Chordal thickening 3. Restricted leaflet motion 4. Excessive leaflet tip motion during systole 1. Irregular or focal thickening 2. Coaptation defect 3. Restricted leaflet motion 4. Prolapse
• 9.
  Reference Reményi B, WilsonN, Steer A, Ferreira B, Kado J, Kumar K, Lawrenson J, Maguire G, Marijon E, Mirabel M, Mocumbi AO, Mota C, Paar J, Saxena A, Scheel J, Stirling J, Viali S, Balekundri VI, Wheaton G, Zühlke L, Carapetis J. World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease–an evidence-based guideline. Nat Rev Cardiol. 2012;9:297–309.
• 10.
  Clinical application  http://circ.ahajournals.org/content/early/2014/03/12/CIRCULATIONAHA.113 .003495.abstract
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  Hard work addscomfortable orientation