title: The malignant course of acute rheumatic Fever in the modern era: implications for early surgical intervention in cases of bivalvular insufficiency with impaired ventricular function.
abstract: In recent years, the incidence of acute rheumatic fever (ARF) has drastically decreased in the United States while remaining common in developing nations. However, immigration to the United States from developing nations has resulted in the continued prevalence of ARF. Patients with ARF face the potential development of significant valvular insufficiency and rheumatic carditis, which are associated with significant morbidity and mortality. Potentially adverse outcomes may be avoided with advanced interventions such as aortic and/or mitral valve replacement or repair, the use of inotropic agents, and ventricular assist devices for mechanical circulatory support. This report describes a series of three ARF carditis cases. This series serves not only to emphasize proper ARF prevention, but also to demonstrate the need for timely surgical intervention once medical therapy has failed.
authors.affiliation: Division of Cardiovascular Pathophysiology, Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA.
authors.forename: K
authors.initials: K
authors.lastname: Herrold
authors.forename: E M
authors.initials: EM
authors.lastname: Herrold
authors.forename: A J
authors.initials: AJ
authors.lastname: Bograd
authors.forename: M
authors.initials: M
authors.lastname: Richmond
authors.forename: P A
authors.initials: PA
authors.lastname: Flynn
authors.forename: R S
authors.initials: RS
authors.lastname: Cooper
authors.forename: J M
authors.initials: JM
authors.lastname: Chen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D018450:Disease Progression; D004452:Echocardiography; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D012213:Rheumatic Fever / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D012720:Severity of Illness Index; D014262:Tricuspid Valve Insufficiency / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*