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Diagnostic criteria for rheumatic heart disease based on history, cardiac auscultation, and echocardiographic findings

Diagnostic criteria for rheumatic heart disease based on history, cardiac auscultation, and echocardiographic findings
  Column A Column B Column C
Category of rheumatic heart disease

Presence or history of proven acute rheumatic fever

AND/OR

Finding on clinical cardiac auscultation (ie, presence of pathological murmur of MR, MS, AR, and/or AS)

AND/OR

Echocardiographic structural and functional changes of MS without murmur (ie, silent MS)
Echocardiographic valvular structural abnormality (ie, typical rheumatic valve morphology according to the World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease) Echocardiographic functional abnormality (ie, presence of significant valve regurgitation according to the World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease)
Definite (presence of at least two of the abnormalities described in columns A, B, and C) + + +
Borderline (presence of abnormalities described in either column B or C) + +
Normal (none of the abnormalities described in columns A, B, and C)
MR: mitral regurgitation; MS: mitral stenosis; AR: aortic regurgitation; AS: aortic stenosis.
Data from:
  1. WHO Technical Report Series. Rheumatic fever and rheumatic heart disease: Report of a WHO expert panel, Geneva 29 October - 1 November 2001. Geneva: WHO; 2004.
  2. Remenyi B, Wilson N, Steer A, et al. World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease - an evidence-based guideline. Nat Rev Cardiol 2012; 9:297.
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