TABLE 2

2012 WHF Guidelines for Echocardiographic Diagnosis of RHD in Patients Aged <20 Years

Definite RHD
 A. Pathologic MR and at least 2 morphologic featuresa of RHD of the MV
 B. MS mean gradient >4 mm Hgb
 C. Pathologic AR and at least 2 morphologic featuresa of RHD of the AVc
 D. Borderline disease of both the AV and MV
Borderline RHD
 A. At least 2 morphologic features of RHD of the MV without pathologic MR or MS
 B. Pathologic MR
 C. Pathologic AR
  • AR, aortic regurgitation; AV, aortic valve; MR, mitral regurgitation; MS, mitral stenosis; MV, mitral valve.

  • a Morphologic features include MV: anterior leaflet thickening, chordal thickening, restricted leaflet motion, excessive leaflet tip motion during systole; and AV: irregular or focal thickening, coaptation defect, restricted leaflet motion, prolapse.

  • b Congenital MV anomalies must be excluded.

  • c Bicuspid AV and dilated aortic root must be excluded.