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Articles |

THE EARLY DIAGNOSIS OF RHEUMATIC HEART DISEASE IN CHILDREN

MAX SEHAM, M.D.; M. J. SHAPIRO, M.D.; EUNICE H. HILBERT, M.D.
Am J Dis Child. 1931;42(3):503-525. doi:10.1001/archpedi.1931.01940150002001.
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In spite of the extensive literature on rheumatic heart disease, there is still much to be learned regarding the natural history and epidemiology of rheumatism in juvenile patients and the methods of recognizing valvular disease in the earliest stages.

Our purpose in this paper is threefold: (1) to classify all patients admitted between the years 1923 and 1930 to the Minneapolis Lymanhurst Clinic for children; (2) to offer a scheme for the differential diagnosis of heart disease, and (3) to discuss and relate in the order of their importance the five chief methods of diagnosis, namely, (a) etiologic, (b) structural or anatomic, (c) functional, (d) roentgenologic and (e) electrocardiographic.

During the period from 1923 to 1930, 809 children between the ages of 5 and 16 were admitted to the Minneapolis Lymanhurst Heart Clinic. These children were referred to the clinic because of signs and symptoms indicative of heart disease or

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