Acute heart failure as an initial symptom of pediatric rheumatic carditis: clinical analysis of 10 cases
10.3760/cma.j.cn101070-20220620-00745
- VernacularTitle:以急性心力衰竭为首发症状的儿童风湿性心脏炎10例临床分析
- Author:
Lin LIU
1
;
Zhenheng OU
;
Weiqun TAN
;
Yanhua LIU
;
Boning LI
;
Cong LIU
Author Information
1. 深圳市儿童医院心血管内科，深圳 518026
- Keywords:
Rheumatic fever;
Carditis;
Rheumatic heart disease;
Mitral insufficiency;
Heart failure
- From:
Chinese Journal of Applied Clinical Pediatrics
2022;37(21):1669-1673
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical manifestations, pathological characteristics, treatment and prognosis of pediatric rheumatic carditis with the initial symptom of acute heart failure, and to improve the clinical understanding of the disease.Methods:The clinical data, laboratory examination results, imaging findings, treatment and prognosis data of 10 cases with acute rheumatic carditis were collected and analyzed retrospectively.The patients pre-sented with acute heart failure as the first symptom and were treated in Shenzhen Children′s Hospital from January 2015 to February 2022.Results:There were 4 males and 6 females in this study.The mean age was 9.1 years (3 years and 1 month to 11 years and 3 months), and the average onset age was (9.3 ± 3.2) days (4-14 days). All the 10 cases had circulation symptoms.Besides, 4 cases were also complicated with joint symptoms, 3 cases with neurological symptoms and 2 cases with skin symptoms.Echocardiography revealed mitral valve diseases in all cases.More specifically, combined valve diseases were found in 5 cases, pure mitral regurgitation in 3 cases, and mixed mitral valve diseases (mitral regurgitation complicated with mitral stenosis) in 2 cases.After receiving antibiotic therapy, anti-infection treatment and anti-heart failure therapy, symptoms improved in all patients and valve lesions were alleviated.All patients were followed up for 6 months to 6 years.Six cases had persistent rheumatic heart disease during the follow up.Conclusions:Pediatric rheumatic carditis with the initial symptom of acute heart failure is characterized by early onset and the typical manifestation of rheumatic fever.Mitral valve disease is the commonest lesion.Echocardiography is of great value for the early diagnosis of the disease.Medical treatment is effective, but the incidence of chronic rheumatic heart disease is still high.
