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valvular lesions. Results: Carditis was diagnosed clinically in 56% whereas 2D Echo Doppler done in all patients with suspicion of RF, RHD increased the sensitivity of detection of RF/Carditis to 90.6%. Also the specificity and positive predictive value of 2D Echo Doppler was 100%. In our study clinically only 25.5% patients were diagnosed to have different types of valvular lesions by auscultation and ECG against which 48% patients were diagnosed and proved by echocardiography to have RF & RHD. Conclusion: Echocardiography increases yield of RF & RHD in patients with acute rheumatic fever (p value>.0138) and is also helpful in mixed valve lesions to determine severity of each lesion. Subclinical cases of RF can be picked up with Echo Doppler so that timely treatment and prevention can reducemorbidity and mortality.

Calculation of Time in Therapeutic Range (TTR) in valve clinic follow up patients with mechanical heart valve replacement