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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