[Rheumatic cardiopathy in children. A comparative study in 2 consecutive 9-year periods]

The case rate of children observed with rheumatic carditis or rheumatic heart disease during two consecutive periods of nine years are compared. The first was from October 1969 to September 1978, with previously published data, and the present study from October 1978 to September 1987. During the second period there were 38 cases, 26 of which had the first attack in Portugal, with isolated carditis in 18 (69%), associated with polyarthritis in 5 (20%) and associated with chorea in 3 (11%). Isolated mitral insufficiency was the most frequent valve lesion (80%) and 84% of the children were in NYHA class I and II when first seen. Eighteen children were followed during an average of 2.7 years and there was good compliance of secondary prevention in 78% of them with improvement of the valve lesion. The 12 cases referred from the african countries of portuguese language were more severe, and studied separately. Comparing with the first 9 years period, the case rate of rheumatic carditis, per year decreased from 12.5 to 2.3, the mortality was reduced and the clinical presentation was different, with earlier detection, milder forms and better compliance to secondary prevention.