Echocardiographic evaluation of rheumatic carditis in acute rheumatic fever

In this large, prospective study of 108 rheumatic fever patients, mitral valve involvement was the most common feature of rheumatic carditis; such involvement usually manifested as mitral regurgitation. Valvular nodules were observed in a quarter of the patients with carditis. The most common mechanism of mitral regurgitation in rheumatic carditis is ventricular dilatation or restriction of leaflet mobility (the latter in patients with recurrent carditis), or both. We did not find that any incremental information was added by Doppler echocardiography in the diagnosis of rheumatic carditis when there was no evidence of carditis at clinical examination.