A systemic inflammatory disease, characterised by acute attacks of fever spaced by remissions, the presence of acute joint disorder, endocarditis and pericarditis. Other symptoms include chorea, subacute nodules, and erythema marginatum. Onset often follows scarlet fever, streptococcal sore throat, and tonsillitis, infection with the group A streptococci being considered the principal etiological factor.
Serious complications include cardiac lesions characterized by Aschoff bodies, a collection of cells and leukocytes in the interstitial tissue, fibrosis, inflammatory reaction, thickening of the mural endocardium, and valvulitis often associated with fibrous scarring and stenosis. Subcutaneous nodules (large fibroid areas), fibrosis and scarring of the synovia, joint capsules, tendons, fasciae, and muscle sheaths; acute inflammatory exudative changes in the blood vessels; and pneumonia may be associated.
Although not first to note the cardiac manifestations of acute rheumatism, Bouillaud was the first to demonstrate the frequency and importance of heart disease co-incident with acute articular rheumatism. He emphasised that endocarditis and pericarditis were to be regarded as of coincidental occurrence in acute articular rheumatism but of noncoincidental occurrence when associated with chronic articular rheumatism.
- J. B. Bouillaud:
Traité clinique du rheumatisme articulaire. Paris, 1832. Traité clinique des maladies du coeur.
2 volumes. Volume 2, page 238. Paris, J. B. Baillière, 1935.
- G. I. Sokolskii:
O revmatizme myschecnoi tkani serdtsa (rheumatismus cordis).
Uchen Zap Imp Mossk Univ, 1838, 12: 568.