Cardiovascular imaging modalities in the diagnosis and management of rheumatic heart disease

Olukayode O Aremu; Petronella Samuels; Stephen Jermy; Evelyn N Lumngwena; Daniel Mutithu; Blanche J Cupido; Sebastian Skatulla; Ntobeko A B Ntusi

doi:10.1016/j.ijcard.2020.09.049

Cardiovascular imaging modalities in the diagnosis and management of rheumatic heart disease

Int J Cardiol. 2021 Feb 15:325:176-185. doi: 10.1016/j.ijcard.2020.09.049. Epub 2020 Sep 25.

Authors

Olukayode O Aremu¹, Petronella Samuels², Stephen Jermy³, Evelyn N Lumngwena⁴, Daniel Mutithu⁵, Blanche J Cupido¹, Sebastian Skatulla⁶, Ntobeko A B Ntusi⁷

Affiliations

¹ Division of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
² Cape Universities Body Imaging Centre, Faculty of Health Sciences, University of Cape Town, South Africa.
³ Cape Universities Body Imaging Centre, Faculty of Health Sciences, University of Cape Town, South Africa; Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, Cape Town, South Africa.
⁴ Division of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa; Department of Medicine, Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa; Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa; Centre for the Study of Emerging and Ee-emerging Infections (CREMER), Institute for Medical Research and Medicinal Plant studies (IMPM), Ministry of Scientific Research and Innovation, Cameroon.
⁵ Division of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa; Department of Medicine, Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa.
⁶ Division of Structural Engineering and Mechanics, Department of Civil Engineering, University of Cape Town, South Africa; Department of Civil Engineering, Centre for Research in Computational and Applied Mechanics (CERECAM), University of Cape Town, South Africa.
⁷ Division of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa; Department of Medicine, Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa; Cape Universities Body Imaging Centre, Faculty of Health Sciences, University of Cape Town, South Africa. Electronic address: ntobeko.ntusi@uct.ac.za.

PMID: 32980432
DOI: 10.1016/j.ijcard.2020.09.049

Abstract

Rheumatic heart disease (RHD) is prevalent in sub-Saharan Africa, where the capacity for diagnosis and evaluation of disease severity and complications is not always optimal. While the medical history and physical examination are important in the assessment of patients suspected to have RHD, cardiovascular imaging techniques are useful for confirmation of the diagnosis. Echocardiography is the workhorse modality for initial evaluation and diagnosis of RHD. Cardiovascular magnetic resonance is complementary and may provide additive information, including tissue characteristics, where echocardiography is inadequate or non-diagnostic. There is emerging evidence on the role of computed tomography, particularly following valve replacement surgery, in the monitoring and management of RHD. This article summarises the techniques used in imaging RHD patients, considers the evidence base for their utility, discusses their limitations and recognises the clinical contexts in which indications and imaging with various modalities are expanding.

Keywords: Acute rheumatic fever; Cardiovascular magnetic resonance; Computed tomography; Echocardiography; Rheumatic heart disease.

MeSH terms

Echocardiography
Humans
Rheumatic Fever*
Rheumatic Heart Disease* / diagnostic imaging
Rheumatic Heart Disease* / therapy
Tomography, X-Ray Computed