Echocardiographic screening for rheumatic heart disease.

摘要: Rheumatic fever is a delayed sequel to throat infection by group A streptococcus. More than one third of affected children develop carditis, followed many years later – especially in the case recurrent rheumatic infections progressive and permanent valvular lesions, known as heart disease. 2 disease now largely restricted developing countries most reduction its incidence wealthy attributable better living conditions with consequent reductions transmission streptococci. Nevertheless, decline industrialized emphasis on diseases such malaria HIV countries, there has been parallel research into this still prevalent important condition. 3 remains an obvious public health burden across world causing more 200 000 deaths year. 4 An exaggerated immune response specific bacterial epitopes susceptible host thought be basis 5 usually results from cumulative damage episodes acute fever. It reported that after first episode cardiac ausculta tion becomes unremarkable one-third but even these may progress significant valve life, confirmed echocardiography. 6 Thus early detection “subclini cal” vital, it presents opportunity for at time when prophylactic penicillin prevent can progression young adult life. Early school traditionally done listening murmurs stethoscope, echocardiographic confir mation only suspected cases. Recently, we did systematic screening schools Cambodia Mozambique, assess whether could improved using portable ultrasound. 7 We achieved rate echocardiography approximately 10-fold clinical examination only. Such thus makes possible identify risk severe whom secondary prevention prophylaxis effective. Acute prevented antibiotic treatment streptococcal infections, strategy primary prophy