Carditis in acute rheumatic fever in Varanasi, India

In Varanasi carditis is the most important major manifestation of an acute attack of rheumatic fever and is the only one which results in sequelae. In our country carditis constitutes the largest single manifestation of rheumatic fever in its index attack. The overall picture is most distressing with its high incidence (78%), and severity as evidenced by high mortality (70%) in the initial phase. It is necessary to provide institutional treatment for those seriously infected to ensure them the fairest chance of recovery from their carditis without permanent damage to the heart. The diagnosis of carditis is therefore imperative in all cases of acute rheumatic fever even in the absence of other major criteria which may be subdued.