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Related Experiment Videos

Rheumatic fever in children: a 15-year experience in a developing country.

F F Bitar1, P Hayek, M Obeid

  • 1Department of Pediatrics, American University of Beirut, 850 Third Avenue, 18th Floor, New York, NY 10022, USA.

Pediatric Cardiology
|April 8, 2000
PubMed
Summary
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Rheumatic fever (RF) in hospitalized patients often involves carditis and leads to significant heart valve damage. Initial congestive heart failure (CHF) presentation is a key risk factor for mortality in RF patients.

Area of Science:

  • Cardiology
  • Rheumatology
  • Pediatric Cardiology

Background:

  • Rheumatic fever (RF) is a significant cause of acquired heart disease globally.
  • Long-term sequelae, particularly rheumatic heart disease (RHD), contribute to substantial morbidity and mortality.
  • Understanding the clinical profile and outcomes of hospitalized RF patients is crucial for effective management.

Purpose of the Study:

  • To retrospectively analyze the clinical characteristics, manifestations, and outcomes of hospitalized patients with rheumatic fever.
  • To identify risk factors associated with mortality and the need for surgical intervention in this patient cohort.
  • To highlight the long-term impact of RF on cardiac health and valve function.

Main Methods:

  • Retrospective review of clinical data from 91 hospitalized rheumatic fever patients.

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  • Data collection spanned from 1980 to 1995 at a tertiary hospital in Lebanon.
  • Analysis included patient demographics, clinical manifestations, cardiac valve involvement, surgical interventions, and mortality rates.

    • Main Results:

    • Carditis was the predominant manifestation (93%), with mitral and aortic insufficiency affecting 67% and 35% of patients, respectively.
    • Forty-four percent presented with acute congestive heart failure (CHF), and 11% had pericardial effusion.
    • Overall mortality was 12%, with initial CHF presentation being a significant risk factor for mortality (p = 0.006) and surgical intervention.

    Conclusions:

    • Rheumatic fever in hospitalized patients, particularly those with carditis, is associated with severe cardiac valve disease and significant mortality.
    • Early presentation with congestive heart failure is a critical predictor of adverse outcomes, including increased need for surgery and higher mortality.
    • The study underscores the substantial burden of rheumatic heart disease and the importance of timely and aggressive management strategies.