Abstract
It has been accepted genrally that three fourth of patients with chorea minor were proceeded by rheumatic fever. In such a case, it is seldom that patient appears to be seen with physical findings of chorea minor more dominant than rheumatic fever because of apparent findings.
It is the purpose of this paper to present 2 cases of patients with the chief complaints considering chorea minor, discovering the carditis and were followed phonocardiographically.
These 11 and 6 years old females were seen in our clinic because of incoordination of the extremities, emotional instablility and/or speech desturbance. The first case was noticed to have carditis upon first visit, while the latter to have carditis by the follow-up study.
Clinical findings, phonocardiographic examination and other laboratory studies revealed the diagnosis of rheumatic fever in these two patients.
The phonocardiographic studies were performed weekly in these cases employing a “Multifilter system phonocardiograph”. The recordings were made in a supine position at the end of expiration on the apex, pulmonic, aortic and Erb's area. Also, the recordings were made during normal respiration on the pulmonic area to examine the (respiratory) splitting of second heart sound.
The specific features were as follows : pan-systolic decrescend murmur, mid diastolic murmur in acute stage, galloping rhythm of apical area and relatively fixed splitting of pulmonic second sound. Effective results were obtained by the treatment of glucocorticosteroid in both cases.
