Acute rheumatic fever diagnosis and management: review of the global implications of the new revised diagnostic criteria with a focus on Saudi Arabia

Publication date: Available online 13 August 2019Source: Journal of the Saudi Heart AssociationAuthor(s): Jubran Alqanatish, Abdulmajeed Alfadhel, Areej Albelali, Dhafer AlqahtaniAbstractRheumatic fever (RF) is a common cause of acquired heart disease in children worldwide. It is a delayed, non-suppurative, autoimmune phenomenon following pharyngitis, impetigo, or scarlet fever caused by group A β-hemolytic streptococcal (GAS) infection. Rheumatic fever diagnosis is clinical and based on revised Jones criteria. The first version of the criteria was developed by T. Duckett Jones in 1944, then subsequently revised by the American Heart Association (AHA) in 1992 and 2015. However, RF remains a diagnostic challenge for clinicians due to the lack of specific clinical or laboratory findings. As a result, it has been difficult for some time to maintain a balance between over- and under-diagnosis of RF cases.The Jones criteria were revised in 2015 by the AHA, and the main modifications were as follows: The population was subdivided into moderate-to-high risk and low risk, the concept of subclinical carditis was introduced, and monoarthritis was included as a feature of musculoskeletal inflammation in the moderate-to-high risk population. This review will highlight the major changes in the AHA 2015 revised Jones criteria for pediatricians and general practitioners.
Source: Journal of the Saudi Heart Association - Category: Cardiology Source Type: research