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Table 1 WHF criteria for echocardiographic diagnosis of rhd for individuals ≤ 20 years

From: Prevalence and risk factors for Subclinical Rheumatic Heart Disease among primary school children in Dar es Salaam, Tanzania: a community based cross-sectional study

Definite RHD (either A, B or C)

 (A) Pathological MR and at least two morphological features of RHD of the MV

 (B) MS mean gradient ≥ 4 mmHg

 (C) Pathological AR and at least two morphological features of RHD of the AV

 (D) Borderline disease of both the AV and MV

Borderline RHD (either A, B or C)

 (A) At least two morphological features of RHD of the MV without pathological MR or MS

 (B) Pathological MR

 (C) Pathological AR

Normal echocardiographic findings (all of A, B, C and D)

 (A) MR that does not meet all four Doppler echocardiographic criteria (physiological MR)

 (B) AR that does not meet all four Doppler echocardiographic criteria (physiological AR)

 (C) An isolated morphological feature of RHD of the MV (for example, vulvular thickening) without any associated pathological stenosis or regurgitation

 (D) Morphological feature of RHD of the AV (for example, vulvular thickening) without any associated pathological stenosis or regurgitation

Normal echocardiographic findings (all of A, B, C and D)

 (A) MR that does not meet all four Doppler echocardiographic criteria (physiological MR)

 (B) AR that does not meet all four Doppler echocardiographic criteria (physiological AR)

 (C) An isolated morphological feature of RHD of the MV (for example, vulvular thickening) without any associated pathological stenosis or regurgitation

 (D) Morphological feature of RHD of the AV (for example, vulvular thickening) without any associated pathological stenosis or regurgitation

Criteria for Pathological mitral regurgitation

(All four Doppler echocardiographic criteria must be met)

  Seen in two views (apical four chamber view and parasternal long axis or short axis view)

  In at least one view, jet length ≥ 2 cm

  Velocity ≥ 3 m/s for one complete envelope

  Pan-systolic jet in at least one envelope

Criteria for Pathological aortic regurgitation

(All four Doppler echocardiographic criteria must be met)

  Seen in two views

  In at least one view, jet length ≥ 1 cm

  Velocity ≥ 3 m/s in early diastole

  Pan-diastolic jet in at least one envelope

Morphological features of RHD in the MV

 AMVL thickening ≥ 3 mm

 Chordal thickening

 Restricted leaflet motion

 Excessive leaflet tip motion during systole

Morphological features of RHD in the AV

 Irregular or focal thickening

 Coaptation defect

 Restricted leaflet motion

 Prolapse

  1. WHF World Heart Federation, MR mitral regurgitation, RHD rheumatic heart disease, MV Mitral valve, MS mitral stenosis, AR Aortic regurgitation, AV aortic valve, AMVL anterior mitral valve leaflet
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BMC Cardiovascular Disorders

ISSN: 1471-2261

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