Valvular Heart Disease Department, Heart Institute (InCor), University of São Paulo Medical School , São Paulo , Brazil.
Front Pediatr. 2014 Nov 20;2:126. doi: 10.3389/fped.2014.00126. eCollection 2014.
Rheumatic fever (RF) remains endemic in many countries and frequently causes heart failure due to severe chronic rheumatic valvular heart disease, which requires surgical treatment. Here, we report on a patient who underwent an elective surgical correction for mitral and aortic valvular heart disease and had a post-operative diagnosis of acute rheumatic carditis. The incidental finding of Aschoff bodies in myocardial biopsies is frequently reported in the nineteenth-century literature, with prevalences as high as 35%, but no clinical or prognostic data on the patients is included. The high frequency of this finding after cardiac surgery in classical reports suggests that these patients were not using secondary prophylaxis for RF. We discuss the clinical diagnosis of acute rheumatic myocarditis in asymptomatic patients and the laboratorial and imaging methods for the diagnosis of acute rheumatic carditis. We also discuss the prognostic implications of this finding and review the related literature.
风湿热（RF）在许多国家仍然流行，常因严重的慢性风湿性心脏瓣膜病导致心力衰竭，需要手术治疗。在此，我们报告了一例患者，该患者因二尖瓣和主动脉瓣心脏疾病接受了择期手术矫正，并在术后诊断为急性风湿性心肌炎。在 19 世纪的文献中，经常有心肌活检中发现阿绍夫小体的报道，其患病率高达 35%，但没有关于这些患者的临床或预后数据。在经典报告中，心脏手术后发现这种情况的频率很高，这表明这些患者没有使用 RF 的二级预防。我们讨论了无症状患者的急性风湿性心肌炎的临床诊断以及急性风湿性心肌炎的实验室和影像学诊断方法。我们还讨论了这一发现的预后意义，并回顾了相关文献。
