الفهرس 
Chapter I 1. IntroductionOnly 14 pages are availabe for public view
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Abstract
Rheumatic heart disease (RHD) is one of the most common
acquired cardiovascular disease in children and young adults. Rheumatic
fever is a systemic, non-suppurative inflammatory complication of
untreated pharyngeal infection with group A beta hemolytic streptococci,
which is characterized by inflammatory lesions primarily involving the
heart, joints and subcutaneous tissue. Acute rheumatic carditis develops
in 40% to 50% of patients with a first attack of acute rheumatic fever.
Rheumatic fever typically occurs in children between the ages of 5
and 15 years, however, any age-group may be affected. Males and
females are equally susceptible.
RHD was diagnosed by auscultating for a heart murmur.
Echocardiography has proven to be more sensitive and specific than
auscultation. RHD detected on echocardiography without an associated
clinically pathological cardiac murmur is referred to as subclinical RHD.
This study detect the prevalence of rheumatic heart disease among
school children in Damietta district.
The present study was a prospective study included 5000 students;
2578 males and 2422 female from primary and preparatory governmental
and private schools. For each child, a full questionnaire obtained. All
students were belonging to the age group 6-15 years old.
The students were sent for further evaluation by consultant
cardiologist and echocardiographer for identification of the cases of
rheumatic heart diseases The mean age in the present study was 10.4 ± 2.4. There were
(10.1%) of students had history of sore throat, (12.8%) had past history
of recurrent fever, (5.2%) had past history of tonsillitis, (0.1%) had past
history of Arthritis, (0.8%) had past history of arthralgia, (1.52%) had
past history of long acting penicillin intake and (6.20%) had past history
of Antibiotics intake.
The cardiac examination among studied students were17 (0.34%)
with apical murmer on mitral area, 3 (0.06%) with early systolic blowing
murmer on aortic area and 24 (0.48%) with early systolic blowing
murmur on pulmonary area. There were (0.06%) with distended
abdomen, (0.02%) with palpable liver and (0.02%) with palpable spleen.
In the present study, there were 135 cases (2.7%) with abnormal
history and examination; 36 of them (0.72%) receive long acting
penicillin, 15 cases (0.30%) with family history of rheumatic heart
diseases and 44 cases (0.88%) discovered murmer on auscultation.
In the present study, there were 11 student refused echo
examinations. The echocardiographic findings among 124 selected
students, which were (3.2%) definite RHD, (0.8%) borderline RHD and
(15.3%) abnormal structural heart. The prevalence rate of RHD was
0.1%. In Damietta district.
According to our study we are now about to be low risk
populations (prevalence rate <2 per 100.000school aged children) so we
will follow Jones criteria that revised criteria that revised by AHA 2015
depending on prevalence of RHD (low risk or high risk population)
(Gewitz et al., 2015.