Background: Echocardiography can diagnose carditis more accurately than traditional auscultations. There is a great need for echocardiographic criteria for the precise and early diagnosis of both clinical and subclinical carditis, so that it can be included in Jones’ criteria
Aim: Our study is to propose Echocardiographic criteria and test its efficacy
Material and Methods: 333 Consecutive, suspected cases of acute rheumatic fever, underwent a detailed clinical examination; laboratory tests and meticulous Echocardiographic and Doppler study. Vijay’s echo criteria for the diagnosis of carditis / subclinical valvulitis was used by giving 2 points for each of the eight Echo features of carditis.
Results: Out of 333 cases, 220 (66.06%) were both Jones’ positive and Echo positive [True +ve], 52 cases (15.61%) probably had subclinical carditis because though clinically murmur was not heard and Jones’-ve the Echo was Positive[False - ve]. Four cases though, clinically were diagnosed as carditis and were +ve by Jones’criteria ,on Echo showed other diseases [False +ve]. Remaining 57 cases (17.11%) who, were Jones’-ve and clinically as well as echocardiographically negative were taken as control group (True –ve). Sensitivity is 81%, Specificity is 93%.
Conclusions: Vijaya’s Echo criteria plays an important role in precise diagnosis of clinical and subclinical Carditis. . Therefore echocardiography should be included as a major criteria in Jones criteria.