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RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE IN CHILDREN AS SEEN IN CLINIC PRACTICE

RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE IN CHILDREN AS SEEN IN CLINIC PRACTICE IT IS GENERALLY conceded that in the many cardiac clinics rheumatic heart disease is frequently overdiagnosed and underdiagnosed. The fact that this situation obtains is evidence of the inadequacy of the present diagnostic criteria used in most clinics. It is evident that the clinical manifestations of rheumatic fever have undergone a vast change of character. The magnitude of the shift is perhaps not generally appreciated and is not reflected in the textbook descriptions of rheumatic fever.1 These continue to describe classic attacks of rheumatic fever in terms of polyarthritis, fever, elevated sedimentation rate, arthralgias, and prolonged P-R intervals. In our experience and in the experience of most students of rheumatic fever, these cases are now rarely encountered. Major and minor criteria,2 when present, are of utmost diagnostic importance, but these are absent in the great majority of cases seen in the clinic. The "typical" case, in our experience, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American journal of diseases of children American Medical Association

RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE IN CHILDREN AS SEEN IN CLINIC PRACTICE

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Publisher
American Medical Association
Copyright
Copyright © 1954 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0096-8994
eISSN
1538-3628
DOI
10.1001/archpedi.1954.02050100429001
Publisher site
See Article on Publisher Site

Abstract

IT IS GENERALLY conceded that in the many cardiac clinics rheumatic heart disease is frequently overdiagnosed and underdiagnosed. The fact that this situation obtains is evidence of the inadequacy of the present diagnostic criteria used in most clinics. It is evident that the clinical manifestations of rheumatic fever have undergone a vast change of character. The magnitude of the shift is perhaps not generally appreciated and is not reflected in the textbook descriptions of rheumatic fever.1 These continue to describe classic attacks of rheumatic fever in terms of polyarthritis, fever, elevated sedimentation rate, arthralgias, and prolonged P-R intervals. In our experience and in the experience of most students of rheumatic fever, these cases are now rarely encountered. Major and minor criteria,2 when present, are of utmost diagnostic importance, but these are absent in the great majority of cases seen in the clinic. The "typical" case, in our experience,

Journal

American journal of diseases of childrenAmerican Medical Association

Published: Oct 1, 1954

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