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Pericardial Effusion in Patients with Rheumatic Fever.

Journal of the Korean Pediatric Society 1982;25(12):1225-1233.
Published online December 31, 1982.
Pericardial Effusion in Patients with Rheumatic Fever.
In Suck Seo, Hee Ju Kim, Jae Ho Lee, Yong Soo Yoon, Yong Choi, Chang Yee Hong
Department of Pediatrics, Seoul National University Medical School
류마티성 심막염의 임상적 고찰 심에코도와 X-선소견 및 심전도와 비교관찰을 중심으로
서인석, 김희주, 이재호, 윤용수, 최 용, 홍창의
서울대학교 의과대학 소아과학교실
Abstract
Pericarditis denotes worse prognosis in patients with rheumatic fever. During the period of 4 years from Jan. 1978 to Dec. 1981, one hundred and eighteen patients were diagnosed as rheumatic fever on the basis of revised Jones* criteria. One hundred and one patients of them were evaluated with M-mode echocardiography, and were analysed according to Horo- witz^ classification of pericardial effusion. The results were as follows. 1) Carditis were present in 108 patients. 2) On echocardiographic examination in 97 patients with carditis, Horowitz type D were present in 27 patients, type C2 in 11 patients, type C! in 10 patients. Significant effusion was noted in 38 patients(39%). Echocardiography was superior to the conventional methods with EKG or chest X-ray in the detection of pericardial effusion. 3) Chest X-ray showed sensitivity of 60% (23/38) and specificity of 85% (48/53) in the detection of the pericardial effusion. 4) EKG showed sensitivity of 13% (6/47) and specificity of 100% (119/119) in the detection, of the pericardial effusion. 5) The incidence of congestive heart failure, the sex ratio and the duration of the disease did not show statistically significant difference between the effusion group and the non-effu- sion group. 6) Eight patients died of rheumatic fever (fatality rate: 7%). Five of them showed per- icardial effusion.


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