Acute rheumatic fever and valvular damage

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In a number of studies 1, 2, 3 of rheumatic fever, it has been emphasized that the age of the patient at the onset of the disease, the number of attacks, and the character of the illness are important factors in the development of permanent valvular damage. The concept that factors inherent in the patient himself may be of equal or greater importance has received little attention. The present study is an attempt to evaluate the relative importance of the character of the disease, as opposed to the constitutional make-up of the patient, in determining the occurrence of permanent cardiac damage after rheumatic fever.