Document Detail

Use of Doppler Echocardiography to Support the Decision to Discontinue Secondary Prophylaxis for Patients With Rheumatic Fever and Normal Cardiac Auscultation.
MedLine Citation:
PMID:  23239309     Owner:  NLM     Status:  Publisher    
Secondary prophylaxis remains the safest way to prevent or minimize heart valve damage in patients with rheumatic fever. However, criteria to determine the duration of prophylaxis have not been well established. This study aimed to evaluate the clinical and Doppler echocardiographic profile of patients with rheumatic fever and a normal clinical examination at least 5 years after the first episode and to discuss the contribution of Doppler echocardiography in supporting the decision to discontinue secondary prophylaxis. An observational longitudinal study analyzing 183 patients with rheumatic fever and a normal clinical examination 5 years or more after the initial attack was conducted. The patients underwent Doppler echocardiography to study the severity of mitral or aortic valvular disease. Of the 183 patients, 77 (42 %) had clinical carditis. Subclinical chronic heart disease occurred for 79 % of the patients with previous clinical carditis and for 25 % of the patients without clinical carditis. Of the 35 patients with previous clinical carditis who were in the period of discontinued prophylaxis, residual valvular heart disease was observed in all, whereas of the 62 patients without clinical carditis, only 27 % showed residual valvular heart disease. Considering Doppler echocardiographic criteria, prophylaxis would be continued for 13 (34 %) of the patients with previous clinical carditis and for only 2 (3 %) of those without clinical carditis. Return of cardiac auscultation to normal is not always accompanied by return of Doppler echocardiographic findings to normal. Criteria regarding Doppler echocardiographic findings and valve morphology should be evaluated by the time secondary prophylaxis is discontinued. However, further studies are needed to demonstrate whether prolonged prophylaxis provides any benefit to patients with persistent echocardiographic findings.
Fátima Derlene da Rocha Araújo; Eugênio Marcos de Andrade Goulart; Zilda Maria Alves Meira
Related Documents :
24401219 - Subclinical cardiovascular disease in plaque psoriasis: association or causal link?
24469429 - Immediate-term effects of use of an ankle-foot orthosis with an oil damper on the gait ...
24612419 - Enhanced expression of hemoglobin scavenger receptor and heme oxygenase-1 is associated...
23800549 - Real-time three-dimensional transesophageal echocardiography in the assessment of mecha...
24283859 - Distribution of low-density lipoprotein and high-density lipoprotein subclasses in pati...
24611519 - Enhanced formation and impaired degradation of neutrophil extracellular traps in dermat...
16846439 - Significance of qrs duration changes in the evaluation of st-segment depression present...
9338049 - Low igg subclass levels in brittle asthma and in patients with exacerbations of asthma ...
11790929 - The brugada syndrome.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-13
Journal Detail:
Title:  Pediatric cardiology     Volume:  -     ISSN:  1432-1971     ISO Abbreviation:  Pediatr Cardiol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil,
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Polyphyly of the Padus group of Prunus (Rosaceae) and the evolution of biogeographic disjunctions be...
Next Document:  Effects of Circuit Residual Volume Salvage Reinfusion on the Postoperative Clinical Outcome for Pedi...