Table 2

World Heart Federation criteria for diagnosis of RHD in patients ≤20 years old

Definite: either A, B, C or D

  1. Pathological MR and at least two morphological features of RHD of the mitral valve

  2. Mitral stenosis with mean gradient ≥4 mm Hg

  3. Pathological AR and at least two morphological features of RHD of the aortic valve

  4. Borderline disease of both the aortic and mitral valves

 
Borderline: either A, B or C

  1. At least two morphological features of RHD of the mitral valve

  2. Pathological MR

  3. Pathological AR

 
Pathological MR (all criteria must be met)Pathological AR (all criteria must be met)
Seen in two viewsSeen in two views
Jet length ≥2 cm (in at least one view)Jet length ≥1 cm (in at least one view)
Velocity ≥3 m/s for one complete envelopeVelocity ≥3 m/s for one complete envelope
Pansystolic jet in at least one envelopePandiastolic jet in at least one envelope
Morphological features of the mitral valveMorphological features of the aortic valve
Anterior leaflet thickening ≥3 mmIrregular or focal thickening
Chordal thickeningCoaptation defect
Restricted leaflet motionRestricted leaflet motion
Excessive leaflet tip motion during systoleProlapse

  • AR, aortic regurgitation; ID, identification; MR, mitral regurgitation jet; PACS, picture archiving and communication system; RHD, rheumatic heart disease.