Echocardiographic Screening of Rheumatic Heart Disease: Current Concepts and Challenges


TOPÇU S., UÇAR T.

Turkish Archives of Pediatrics, cilt.59, sa.1, ss.3-12, 2024 (ESCI) identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 59 Sayı: 1
  • Basım Tarihi: 2024
  • Doi Numarası: 10.5152/turkarchpediatr.2024.23162
  • Dergi Adı: Turkish Archives of Pediatrics
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.3-12
  • Anahtar Kelimeler: Acute rheumatic fever, echocardiographic screening, echocardiography, rheumatic heart disease
  • Ankara Üniversitesi Adresli: Evet

Özet

The incidence of acute rheumatic fever (ARF), which most commonly affects children aged 5-15 years after group A Streptococcus (GAS) infection, ranges from 8 to 51 per 100 000 people worldwide. Rheumatic heart disease (RHD), which occurs when patients with ARF are inappro-priately treated or not given regular prophylaxis, is the most common cause of non-congenital heart disease in children and young adults in low-income countries. Timely treatment of GAS infection can prevent ARF, and penicillin prophylaxis can prevent recurrence of ARF. Secondary prophylaxis with benzathine penicillin G has been shown to decrease the incidence of RHD and is a key aspect of RHD control. The most important factor determining the prognosis of RHD is the severity of cardiac involvement. Although approximately 70% of patients with carditis in the acute phase of the disease recover without sequelae, carditis is important because it is the only complication of ARF that causes sequelae. One-third of patients with ARF are asymptomatic. Patients with mild symptoms of recurrent ARF and silent RHD will develop severe morbidities within 5-10 years if they do not receive secondary preventive treatments. A new screening pro-gram should be established to prevent cardiac morbidities of ARF in moderate-and high-risk populations. In the present study, we examined the applicability of echocardiographic screening programs for RHD.