Acute rheumatic fever vs Rheumatic heart disease
How to tell Acute rheumatic fever and Rheumatic heart disease apart when a board question makes them look alike.
Acute rheumatic fever is the active post-strep inflammatory syndrome; rheumatic heart disease is chronic valve scarring.
Side by side
Post-group A strep immune syndrome with Jones criteria features such as migratory polyarthritis, carditis, chorea, erythema marginatum, and subcutaneous nodules.
Chronic valve scarring years later, especially mitral stenosis or mixed mitral disease.
Molecular mimicry after streptococcal infection causes inflammatory autoimmune disease.
Repeated or severe rheumatic inflammation scars valves and chordae over time.
Evidence of recent strep plus Jones criteria points acute rheumatic fever.
Opening snap, diastolic rumble, atrial fibrillation, or commissural fusion years later points chronic rheumatic heart disease.
The trap
Carditis can occur in acute rheumatic fever, but mitral stenosis years later is chronic disease.
Watch it explained
The repair move
For rheumatic questions, decide whether the timeline is weeks after strep or years after inflammation.
Try a free question
CoreA child develops migratory polyarthritis, carditis, fever, elevated inflammatory markers, and evidence of recent group A strep infection. Which diagnosis is most likely?
Show answer and explanation
Answer: A. Acute rheumatic fever. Acute rheumatic fever is the post-strep immune syndrome diagnosed using Jones criteria plus evidence of recent group A strep infection.
Why the other choices are tempting
- B. Rheumatic heart disease is chronic valve damage after rheumatic fever.
- C. Infective endocarditis is microbial valve infection.
- D. Kawasaki disease causes mucocutaneous findings and coronary aneurysm risk.
- E. JIA is chronic inflammatory arthritis not defined by recent strep/Jones criteria.
Flashcards
Tap a card to flip it.
What is the fastest separator for Acute rheumatic fever vs Rheumatic heart disease?
Acute rheumatic fever is the active post-strep inflammatory syndrome; rheumatic heart disease is chronic valve scarring.
What clue should make you choose Acute rheumatic fever?
Post-group A strep immune syndrome with Jones criteria features such as migratory polyarthritis, carditis, chorea, erythema marginatum, and subcutaneous nodules.
Quick answers
What is the fastest way to tell Acute rheumatic fever from Rheumatic heart disease?
Acute rheumatic fever is the active post-strep inflammatory syndrome; rheumatic heart disease is chronic valve scarring.
What is the key clue for Acute rheumatic fever?
Post-group A strep immune syndrome with Jones criteria features such as migratory polyarthritis, carditis, chorea, erythema marginatum, and subcutaneous nodules.
What is the key clue for Rheumatic heart disease?
Chronic valve scarring years later, especially mitral stenosis or mixed mitral disease.
What is the common trap with Acute rheumatic fever vs Rheumatic heart disease?
Carditis can occur in acute rheumatic fever, but mitral stenosis years later is chronic disease.