RHEUMATIC HEART DISEASE IN CHILDREN AND AORTIC VALVE CHANGES: PATHOPHYSIOLOGICAL AND CLINICAL PERSPECTIVES
Abstract
Rheumatic heart disease (RHD) remains a significant cause of acquired cardiovascular morbidity in children, particularly in low- and middle-income regions. It develops as a chronic sequela of acute rheumatic fever following untreated or inadequately treated group A streptococcal infection. Although mitral valve involvement is most common, aortic valve pathology is frequently observed and contributes to progressive hemodynamic deterioration. This article reviews the pathophysiological mechanisms, echocardiographic features, and clinical implications of aortic valve changes in pediatric rheumatic heart disease. Emphasis is placed on early diagnosis, Doppler echocardiographic assessment, and long-term management strategies aimed at preventing irreversible valvular damage.
Keywords
rheumatic heart disease, children, aortic valve, aortic regurgitation, echocardiography, valvular heart disease.
References
- Carapetis JR, et al. Acute rheumatic fever and rheumatic heart disease. Lancet, 2005.
- Gewitz MH, et al. Revision of Jones Criteria for ARF diagnosis. Circulation, 2015.
- Otto CM. Textbook of Clinical Echocardiography. Elsevier, 2018.
- Zühlke L, et al. Rheumatic heart disease in children. Nature Reviews Cardiology, 2017.
- Marijon E, et al. Epidemiology of RHD worldwide. Circulation, 2012.
- Reményi B, et al. World Heart Federation criteria for RHD diagnosis. Heart, 2012.
- Narula J, et al. Pathogenesis of rheumatic heart disease. Circulation Research, 2010.
- Watkins DA, et al. Global burden of RHD. NEJM, 2017.