Clinical Characteristics And Echocardiographic Findings Of Patients Diagnosed With Acute Rheumatic Fever

Acute rheumatic fever (ARF) is an acquired cardiac disease, that may develop as a non-supurative, late-onset complication of an infection with group A β-hemolytic Streptococcus, such as pharyngitis or tonsillitis, continues to maintain its importance in developing countries, despite it is relatively rare in developed countries. The aim of this study was to review patients, diagnosed with acute rheumatic fever at our center, and to discuss this disease, which is a major health problem in our country, in the light of recent literature data. Files of patients, who referred to Selçuk University Medical Faculty Hospital, and diagnosed with ARF between January 2010 and February 2014, were assessed, retrospectively, and patient demographic data, clinical and echocardiographic (ECHO) features, treatment responses were identified. A total of 65 patients, including 26 (40%) girls and 39 (60%) boys, diagnosed with ARF, with an average age of 11,6 years (5-17 years) at the time of diagnosis, 16 (24.6%), 11 (16.9%), 5 (7.7%) and 33 (50.8%) of 65 patients has also been diagnosed with carditis, arthritis, carditis and (+) arthritis, and silent carditis, respectively. The most frequently referred symptoms are arthritis and arthralgia, with a 59% rate. Although pathological murmurs and innocent murmurs were identified during physical examination in 25 (38.4%) and 21 (32.3%) patients, respectively; 19 (29.2%) patients had no evidence of heart murmur. The most common findings in echocardiographic assessment are mitral insufficiency (MI), aortic insufficiency (AI), and mitral and aortic valve involvement in 14 (21.5%), 10 (15.4%) and 22 (33.9%) patients, respectively. Acute rheumatic fever continues to be a health-threatining condition in our country. Even if there are no pathological murmur in patients referred with arthritis or arthralgia, with an increased level of acute phase reactants; echocardiographic assessment should be taken.