Choudhury Shahana A, Exil Vernat
Department of Pediatrics, Meharry Medical College, Nashville, TN, USA.
Division of Pediatric Cardiology, Department of Pediatrics, Monroe Carell Children's Hospital At Vanderbilt University, Nashville TN, USA.
SAGE Open Med Case Rep. 2014 Mar 10;2:2050313X14527589. doi: 10.1177/2050313X14527589. eCollection 2014.
Rheumatic heart disease, already a major burden in low- and middle-income countries, is becoming an emerging problem in high-income countries. Although acute rheumatic fever and rheumatic heart disease have almost been eradicated in areas with established economies, the emergence of this problem may be attributable to the migration from low-income to high-income settings. Between 2010 and 2012, we diagnosed a cluster of rheumatic heart disease cases in children from the Middle Tennessee area. The goal of this report is to increase awareness among clinicians as the incidence and prevalence of acute rheumatic fever remain relatively significant in large US metropolitan areas. Although acute rheumatic fever is seasonal, a high suspicion index may lead to the early diagnosis and prevention of its cardiac complications. Furthermore, screening procedures may be recommended for populations at risk for rheumatic heart disease in endemic areas, and active surveillance with echocardiography-based screening might become very important.
风湿性心脏病在低收入和中等收入国家已然是一项重大负担，而在高收入国家正成为一个新出现的问题。尽管在经济发达地区急性风湿热和风湿性心脏病几乎已被根除，但这个问题的出现可能归因于从低收入地区向高收入地区的人口迁移。2010年至2012年期间，我们诊断出田纳西州中部地区儿童中有一组风湿性心脏病病例。本报告的目的是提高临床医生的认识，因为在美国大城市地区急性风湿热的发病率和患病率仍然相当可观。尽管急性风湿热具有季节性，但高度的怀疑指数可能会促成早期诊断并预防其心脏并发症。此外，对于流行地区有风湿性心脏病风险的人群，可能建议进行筛查程序，基于超声心动图筛查的主动监测可能会变得非常重要。
