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PubMed1980

[Rheumatic fever: present status (author's transl)].

In general, there is a falling incidence of rheumatic fever in the Federal Republic of Germany. Data from 1949 to 1977 at the University Children's Clinic Mainz indicate that in the last few years rheumatic carditis and arthritis occurred with the same severity and frequency in relation to the total number of cases as 20--25 years ago. Merely the number of recurrences has been significantly lowered since the introduction of penicillin prophylaxis. The reduction in recurrences is the main reason why acquired heart disease has become less common.

Adolescent↗

PubMed2001

Rheumatic fever recurrence: a possible cause of restenosis after percutaneous mitral valvuloplasty.

BACKGROUND: We evaluated the occurrence of a rapid process of restenosis after percutaneous mitral valvuloplasty (PMV), initiated by the recurrence of acute rheumatic fever. Restenosis after PMV has been mainly related to a high echocardiographic score (> or = 8) indicating a severely compromised mitral valve apparatus. METHODS: From 1986 to 1996, 120 patients underwent PMV by the transseptal approach at our Institution. The mean follow-up time was 58 +/- 32 months (range 3 months to 9 years). RESULTS: Restenosis occurred in 10 patients (8.3%): in 4 restenosis was found within a relatively short period of time (1 to 3 months) following a documented recurrence of acute rheumatic fever; in the other 6 patients there was a gradual loss of the initial gain in the mitral valve area. CONCLUSIONS: These data suggest two potential mechanisms of restenosis: 1) a more common slow process, due to turbulent flow-trauma on the mitral valve; 2) a rapid process that relates to valvulitis consequent to a recurrence of acute rheumatic fever. In consideration of the second possibility, after PMV prophylactic treatment may be warranted at least in those patients who are at high risk of streptococcal infection.

Adolescent↗

PubMed1956