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[Fatal active rheumatic disease. Study of 13 necropsy cases]
L G Velloso1, A J Mansur, M Grinberg
1Instituto do Coração do Hospital das Clínicas, FMUSP, Div. Clínica, São Paulo.
Arquivos Brasileiros De Cardiologia
|April 1, 1991
Summary
Fatal acute rheumatic fever (ARF) can occur even in first-time attacks or in young adults. Intense clinical and laboratory signs can lead to misdiagnosis, highlighting the need for awareness of ARF
Area of Science:
- Cardiology
- Rheumatology
- Pediatric Cardiology
Context:
- Acute rheumatic fever (ARF) is an inflammatory disease that can follow streptococcal infection.
- While often treatable, severe cases can lead to significant morbidity and mortality.
- Understanding the clinical spectrum of fatal ARF is crucial for timely diagnosis and management.
Purpose:
- To investigate the clinical characteristics of patients who experienced fatal outcomes from acute rheumatic fever.
- To identify patterns and potential diagnostic challenges in severe ARF cases.
Summary:
- This study analyzed 13 patients with fatal ARF, aged 4.5 to 25 years, presenting with fever and severe heart failure.
- All patients exhibited mitral insufficiency; echocardiograms revealed valvular vegetations in some.
- Clinical and laboratory findings were intense, sometimes leading to consideration of alternative diagnoses.
Impact:
- Fatal ARF underscores the continued risk of this preventable disease, even in previously unaffected individuals.
- Highlights the importance of recognizing severe ARF presentations to prevent mortality.
- Emphasizes the need for heightened clinical suspicion for ARF, especially with severe cardiac involvement.