[Clinical evolution of rheumatic carditis treated with aspirin]

We have analyzed the clinical, laboratory, electrocardiographic and echocardiographic findings of six patients with rheumatic carditis whose antiinflammatory treatment was aspirin. We include one case who was initially treated with steroids. She relapsed when the steroid treatment was discontinued and she was then treated with aspirin. There were 2 males and four females. The age range was 9 to 14 years. This was the first rheumatic attack for all the patients. They were also treated with penicillin G during ten days. The prophylaxis was accomplished with benzatine penicillin 1.200.000 IU at 28 days intervals. The aspirin was given at doses ranging from 60 to 100 mg/Kg/day for eight to twelve weeks. All the patients had auscultatory findings consistent with mitral insufficiency accompanied in two cases with findings of aortic regurgitation. In three cases, there was a transient mild diastolic murmur during the first five days. In one case the rheumatic carditis was complicated with acute renal failure due to acute rheumatic nephritis that required peritoneal dialysis. The follow-up period ranged from nine to twenty six months. There have been no relapses. All the patients remain asymptomatic and leading a normal life. At the last visit three patients had mild mitral insufficiency and in three patients the clinical findings, electrocardiogram and echocardiogram were normal. If we accept that most of the cases of rheumatic carditis are mild or moderate, is our believe that the aspirin is the antiinflammatory treatment of choice at the present time.