Your doctor makes a diagnosis of rheumatic fever based on a physical exam and test results.
Your child's doctor will conduct a thorough physical examination that may include:
- Checking the joints for signs of inflammation
- Checking for fever
- Examining the skin for nodules under the skin or a rash
- Listening to the heart for abnormal rhythms, murmurs or muffled sounds that may indicate inflammation of the heart
- Conducting a series of simple movement tests to detect indirect evidence of inflammation of the central nervous system
Tests for strep infection
If your child was already diagnosed with a strep infection, your doctor may not order any additional tests for the bacterium. If your doctor orders a test, it will most likely be a blood test that can detect antibodies to strep bacteria circulating in the blood. The actual bacteria may no longer be detected in your child's throat tissues or blood.
Electrocardiogram (ECG or EKG)
An electrocardiogram — also called an ECG or EKG — records electrical signals as they travel through your child's heart. Your doctor can look for patterns among these signals that indicate inflammation of the heart or poor heart function.
An echocardiogram uses sound waves to produce live-action images of the heart. This common test may enable your doctor to detect altered structures within the heart. Damage to heart valves isn't likely to occur early in the disease, but an echocardiogram can show such problems. This test may need to be repeated in the future in a patient who has had rheumatic fever to reassess the heart valves based on symptoms or changes in the physical exam.
Feb. 18, 2014
- Bonow RO, et al. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4377-0398-6..C2009-0-59734-6--TOP&isbn=978-1-4377-0398-6&about=true&uniqId=236798031-10. Accessed Aug. 12, 2013.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Aug. 12, 2013.
- Rheumatic fever. The Merck Manuals: The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/pediatrics/rheumatic_fever/rheumatic_fever.html. Accessed Aug. 12, 2013.
- Marijon E, et al. Rheumatic heart disease. The Lancet. 2012;379:953.
- Goldman L, et al. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed Aug. 12, 2013.
- Chow AW, et al. Evaluation of acute pharyngitis in adults. http://www.uptodate.com/home. Accessed Aug. 12, 2013.
- Gibofsky A, et al. Epidemiology and pathogenesis of acute rheumatic fever. http://www.uptodate.com/home. Accessed Aug. 12, 2013.
- Schmitt BD. Pediatric Telephone Protocols. 13th ed. Elk Grove Village, Ill.: American Academy of Pediatrics; 2011:1.
- Mankad R (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 4, 2013.
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