Background: Patients with juvenile idiopathic arthritis (JIA) have a higher risk of cardiac problems, such as left heart failure.

Objectives: This study aimed to accurately evaluate of cardiac functions in children with JIA compared to matched healthy controls.

Subjects and methods: This case control study was conducted at Department of Pediatrics, Cardiology‌ Unit, Rheumatology clinic and clinical pathology department at Zagazig University Hospital on forty children who were allocated into two groups: control group: Twenty apparently normal, healthy children matched to case regarding to age and sex and case group: Twenty children with Juvenile rheumatoid arthritis and on regular follow-up once/month. BNP and echocardiography were assessed for all children.

Results: there was significant variations were detected between case and control groups for TAPSE and TAPSE/RVSP ratio, which were lower in the case group, and RVSV, LVEDD, LVESD, LVEDV, and LVESV, which was higher in the case group. No remarkable variations were observed for TR. There was no marked variations between both groups concerning LV longitudinal strain, LV size, right and left ventricle free wall longitudinal axes strain velocities using 2D speckle tracking except Rv4csl that was significant higher in cases than control (p<0.0001)

Conclusion: Regular cardiac monitoring is crucial in the early detection and management of heart disease in JIA cases, findings from an echocardiogram can help justify aggressive treatment for young cases diagnosed with juvenile rheumatoid arthritis and assess the progression of the disease in these patients.