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[Rheumatic carditis in the adult. Anatomoclinical correlation].

J F Guadalajara1, J J Gual, N Valvuena

  • 1Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.

Archivos Del Instituto De Cardiologia De Mexico
|November 1, 1990
PubMed
Summary
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Active rheumatic fever is often difficult to diagnose in adults, presenting a "silent" clinical-histologic discrepancy. This study highlights challenges in recognizing rheumatic carditis in adults compared to children and adolescents.

Area of Science:

  • Rheumatology
  • Cardiology
  • Pathology

Context:

  • Study of 325 necropsies from the National Institute of Cardiology, Mexico (1980-1985).
  • Focus on 45 cases with Aschoff nodules and valvular inflammation, divided into pediatric (24) and adult (21) groups.
  • Comparison of clinical, histologic, and laboratory findings in active rheumatic fever.

Purpose:

  • To compare the clinical presentation and diagnostic criteria of active rheumatic fever in children-adolescents versus adults.
  • To evaluate the applicability of Jones criteria in adult cases of rheumatic heart disease.
  • To identify discrepancies between clinical suspicion and histologic findings in adult rheumatic fever.

Summary:

  • Active rheumatic fever was suspected in 67% of pediatric cases versus 14.2% of adult cases.

Related Experiment Videos

  • Carditis was the most common Jones criterion, observed in 83% of pediatric and 50% of adult patients.
  • High anti-streptolysin levels indicated active disease in 95% of pediatric patients, while elevated erythrocyte sedimentation rate was noted in 83% of adults.

    • Impact:

    • Jones criteria are often not met in adult active rheumatic fever, leading to diagnostic challenges and a 'silent' disease evolution.
    • Highlights the need for improved diagnostic strategies for rheumatic heart disease in adult populations.
    • Emphasizes the clinical-histologic discrepancy in adult rheumatic fever, underscoring its subtle presentation.