pediatrics
Rheumatic Fever
Prognosis for Rheumatic Fever
Prognosis following an initial episode of acute rheumatic fever depends mostly on how severely the heart is affected, and whether there is a recurrent episode of acute rheumatic fever. Murmurs eventually disappear in about half of patients whose acute episodes were manifested by mild carditis without major cardiac enlargement or decompensation. However, many others develop chronic valvular disease, including some who recovered from the acute episode without evidence of valvular disease. Episodes of Sydenham chorea usually last several months and resolve completely in most patients, but about one third of patients have recurrences. Joint inflammation may take 1 month to subside if not treated but does not lead to residual damage. In patients with chronic valvular disease, symptoms develop and progress slowly, typically over several decades. However, once significant symptoms develop, intervention is usually necessary. In developing countries, chronic rheumatic heart disease is the cause of 25 to 45% of all cardiovascular disease. 