Agarwal P K, Misra M, Sarkari N B, Gupta A K, Agarwal P
Dept of Medicine, BRD Medical College, Gorakhpur.
J Assoc Physicians India. 1998 Nov;46(11):937-8.
Detailed echocardiographic analysis was performed in 10 children with first episode of acute rheumatic fever who presented with acute rheumatic polyarthritis or rheumatic chorea and had no clinically detectable evidence of active carditis. Significant changes were observed in the form of mitral valve prolapse with regurgitation in 3, aortic valve prolapse with regurgitation in 1 and mitral valve billowing without regurgitation in 1 patient each. A significant (p < 0.001) anterior mitral chordal elongation was observed in both the groups--rheumatic polyarthritis and chorea when compared with age and sex matched control subjects. Mitral annular diameter was found to be increased (p < 0.001) in patients presenting with polyarthritis alone. These observations of clinically silent but echocardiographically detectable element of carditis forms the basis of how patients of acute rheumatic fever develop permanent valvular deformities in their latter lives without revealing any cardiac affection earlier.
对10例首次发作急性风湿热的儿童进行了详细的超声心动图分析，这些儿童表现为急性风湿性多关节炎或风湿性舞蹈病，且无临床可检测到的活动性心脏炎证据。观察到显著变化，表现为3例二尖瓣脱垂伴反流，1例主动脉瓣脱垂伴反流，1例二尖瓣膨出但无反流。与年龄和性别匹配的对照组相比，风湿性多关节炎和舞蹈病组均观察到二尖瓣前叶腱索显著延长（p<0.001）。单独出现多关节炎的患者二尖瓣环直径增大（p<0.001）。这些关于心脏炎临床无症状但超声心动图可检测到的表现的观察结果，构成了急性风湿热患者在后期如何发展为永久性瓣膜畸形而早期未显示任何心脏病变的基础。
