Assessment of sociodemographic clinical findings in cases of rheumatic subclinical carditis and comparison the effect of different treatment protocols on prognosis

Subclinical carditis has been identified using Doppler echocardiography in cases of acute rheumatic fever with isolated arthritis, chorea or poliartralgia. Permanent sequelae of acute rheumatic fever depends on the involvement of the heart, so early diagnosis of carditis is important. The efficiency of the treatment and prognosis of subclinical carditis is not clear. We aimed to explain the importance of echocardiography for early detection and to determine retrospectively the relationship between the medication and prognosis.We scanned the patients files at the Department of Pediatric Cardiology, Gazi University School of Medicine, between January 1998 and August 2010 retrospectively and found 40 patients with subclinical carditis. 22 males and 18 females aged 6-16 years presenting with either chorea, arthritis or poliartralgia. Nineteen patients had mitral regurgitation, 18 patients had combined mitral and aortic regurgitation, and three patients had aortic regurgitation. Of the patients, 21 received prednisolone, nine patients received acetylsalicylic acid and 10 received no treatment. The patients were followed over a mean period of 46,81 ± 32,66 months, 15 of the valvar regurgitation disappeared.We compared the treatment protocols of the patients and compare the prognosis of subclinical carditis, we found more patients from the group who received prednisolone recovered fully and recovered earlier than the grup who have not received prednisolone (p<0,05). Based on our study, treatment with prednisolone seems to have a role in fully recovery and we consider starting prednisolone treatment for rheumatic subclinical carditis which can be the early sign of rheumatic carditis, is important to prevent sequelae.