Lu et al identified simple criteria for screening a child in a developing country for rheumatic heart disease using handheld echocardiography. A child with positive findings can be referred for more definitive testing. The authors are from the University of Michigan, National Medical Center Washington, Uganda Heart Institute and Monroe Carell Jr. Children’s Hospital at Vanderbilt.


Patient selection: pediatric in developing country


Testing: handheld echocardiography


Criteria for positive screen – one or both of the following:

(1) mitral regurgitation jet >= 1.5 cm

(2) any degree of aortic insufficiency



• The test had a sensitivity of 73% and specificity of 82% in a population with a prevalence of 4%,

• Screening and referral reduced more complex echocardiography by 80%.


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