It is still used in cases of carditis secondary to rheumatic fever. Other treatments that have been investigated for enteroviral carditis include intravenous immunoglobulin. Some patients develop significant carditis which manifests as congestive heart failure. Lyme carditis should not be treated with corticosteroids. Exceptions are chorea and indolent carditis, each of which by itself can indicate rheumatic fever. His wife died in the house in May 1832, probably of rheumatic carditis. However, in some cases Lyme carditis can be fatal. The official cause of death was Carditis. The four other major criteria include carditis, polyarthritis, Sydenham's Chorea, and subcutaneous nodules. Non-neurologic manifestations of acute rheumatic fever are carditis, arthritis, erythema marginatum, and subcutaneous nodules. In some people, however, carditis may be the first manifestation of Lyme disease.