Table 2.

The WHF 2012 criteria for the echocardiographic diagnosis of RHD.

A) 2012 WHF guidelines for diagnosis of RHD
Definite RHD (either A, B, C or D): A. Pathological MR and at least two morphological features of RHD of the MV B. MS mean gradient ≥4 mmHg C. Pathological AR and at least two morphological features of RHD of the AV D. Borderline disease of both the AV and MV Borderline RHD (either A, B, or C) A. At least two morphological features of RHD of the MV without pathological MR or MS B. Pathological MR C. Pathological AR
B) Criteria for pathological regurgitation
Pathological mitral regurgitation (All four Doppler echocardiographic criteria must be met) Seen in two views. In at least one view, jet length ≥2 cm Velocity ≥3 m/s for one complete envelope Pan-systolic jet in at least one envelope Pathological aortic regurgitation (All four Doppler echocardiographic criteria must be met) See in two views. In at least one view, jet length ≥1 cm Velocity ≥3 m/s in early diastole Pan-diastolic jet in at least one envelope
C) Morphological features of RHD
Features in the MV AMVL thickening ≥3 mm (age-specific) Chordal thickening Restricted leaflet motion Excessive leaflet tip motion during systole Features in the AV Irregular of focal thickening Coaptation defect Restricted leaflet motion Prolapse

WHF: World Heart Federation; RHD: Rheumatic Heart Disease; MR: Mitral Regurgitation; MV: Mitral Valve; AR: Aortic Regurgitation; AV: Aortic Valve; MS: Mitral Stenosis; AMVL: Anterior Mitral Valve Leaflet