Color-Doppler Echocardiograpby in the Assessment of Subclinical Cardiac Involvement in Chorea Minor due to Rheumatic Fever

without clinically evident carditis were evaluated by color-Doppler echocardiography (CDE) in addition to elinical examination. Cardiac involvement was clinically evident in 7 of 25 patients (%28), ie isolated mitral regurgitation (MR) in 5, MR and pericarditis in one, combined mitral and aortic regurgitation (AR) in the other one. Clinical findings were in concordance with the findings by CDE in all patients with clinically evident valvular involvement. Echocardiography disclosed mild but significant valvular regurgitation in 14 (%78) of the remaining 18 patients, in whom clinically no valvular involvement was present. Silent valvular regurgitations encountered in pure chorea were as follows: 9 isolated MR, 2 MR+AR, and 3 isolated AR. The ineidence of cardiac involvement, which was 28% (7/25) by elinical examination alone, significantly increased to 88% (22/25) after adding silent valvular regurgitations detected by CDE. It was concluded that echocardiographically mild but significant valvular regurgitations can be frequently found in chorea minor patients in whom these are clinically undetectable. Hence, CDE should be used to assess silent valvular regurgitation which may modify the duration of prophylaxis in patients with pure chorea.