[Clinical and echocardiographic study of mitral valve in children with severe rheumatic carditis. Aspects of prolapse or rupture].

OBJECTIVE

To describe cases of rheumatic carditis with echocardiographic aspects of prolapse or rupture of mitral structures.

METHODS

We described 16 cases of acute carditis (ages between 5-15 years). In 10 (group 1) there was aspect of mitral prolapse, in 6 (group 2) aspect of "flail". The measurements of anterior chordae and anuli were compared to the ones of 5 cases of chronic rheumatic fever with dilated left ventricle and aortic regurgitation (group 3) and to 20 normal children of same ages. The same measurements were repeated after treatment.

RESULTS

The mean of the measurements in group 1 was; 26.48 +/- 11.46mm-anterior chordae; 32.13 +/- 7.35mm anuli; in the group 2 was respectively 29.63 +/- 4.57mm and 35.63 +/- 7 mm. In the group 3 anterior chordae was 34.52 +/- 6.8mm, anuli: 34.8 +/- 4.61 mm. In the normal group, respectively was: 18.19 +/- 4.26mm and 24.66 +/- 2.85mm. After corticosteroid many cases improved. In the statistical analyses, the measurements among patients of group 1 and 2 compared to normal children, the difference was significant but it was not compared to group 3. Comparing the measurements pre and post treatment the decrease was not significant.

CONCLUSIONS

The acute carditis in these cases lead to significant elongation of anterior chordae and dilatation of anuli, but there was not a significant decrease after treatment.