Related Experiment Videos
[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
Summary
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.
- 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.