Title : Diagnostic value of jones criteria in paediatric rheumatic heart disease patients requiring mitral valve repair
Abstract:
The Jones Criteria remain the cornerstone for diagnosing acute rheumatic fever (ARF), but their sensitivity in diagnosis varies, and reliability in identifying children with progressive rheumatic heart disease (RHD) requiring surgery is uncertain. Our aim was to assess how frequently paediatric patients undergoing mitral valve (MV) repair for RHD fulfilled the Jones Criteria at initial diagnosis. This retrospective study included 53 children under 18 years who underwent MV repair for RHD at a national heart centre from 2011–2016. Clinical data at first presentation, including manifestations fulfilling Jones Criteria and echocardiographic findings, were analysed. Only 49% (n=26) of the children fulfilled Jones Criteria at initial diagnosis. Carditis was the most common major criterion (84.9%), followed by polyarthritis (18.9%). Echocardiography revealed significant mitral valve pathology in all patients. Subclinical or atypical presentations were common, with low rates of positive throat cultures and minor manifestations. A significant proportion of paediatric RHD patients requiring surgery do not meet the Jones Criteria for diagnosis at presentation, highlighting the limitations of relying solely on traditional diagnostic frameworks, which may lead to underdiagnosis. Routine echocardiographic screening in high-risk populations should be considered to improve early detection and timely intervention.
Keywords:
Jones Criteria, rheumatic heart disease, mitral valve repair, children, echocardiography, diagnosis
