[Prevention of recurrence of rheumatic cardiopathy in 564 patients]

In a group of 564 patients with rheumatic heart disease seen in the period from 1971 to 1975, who were under benzatinic prophylaxis, 23% were seen in the clinic and 77% at home. The object of this revision is to analyze the latter group in order to obtain the frequency of pharyngoamigdaline infections, and of relapses. 1. During the observation, those patients who did not present pharyngeal infections had no relapses. On the other hand, all relapses were observed in those patients who presented infections. 2. Those patients who carried out the prophylaxis incorrectly and who also presented pharyngeal infections, had almost twice the percentage of relapses as those who carried out the prophylaxis correctly. 3. In the group with effective prophylaxis, including those cases with or without pharyngeal infection, 5% had recurrences. In the group with ineffective prophylaxis, 16% had relapses. 4. Those patients with subsequent attacks doubled the percentage of relapses in comparison with those with initial attacks. 5. The plurivalvular patients have a higher frequency of recurrences than the univalvular patients. 6. During the first year of post-attack prophylaxis, the incidence of relapses is only 1.7%, in comparison with the following years in which there is a higher incidence of around 10%. 7. The total number of recurrences in 564 patients was 8%.