Rheumatic fever and rheumatic heart disease are usually considered to be diseases of the young. The average age of onset of rheumatic fever has been calculated in several series of cases with rheumatic heart disease. In 3,129 deceased patients studied by Cohn and Lingg1 it was 14.5 ± 0.3 years for males and 15.0 ± 0.3 years for females; in 644 patients observed by De Graff and Lingg2 it was 17 years; in 1,042 children observed by Wilson and Lubschez3 it was 6.5 years. There are reports, however, of initial episodes of rheumatic fever in the seventh decade.4 Among 3,741 patients with rheumatic fever entering Bellevue Hospital from 1911 to 1919, Lambert5 found 91 over the age of 60.
Older data on the duration of life after the initial manifestation of rheumatic fever in the course of rheumatic heart disease indicate a poor prognosis. Cohn
Appel SB, Kossmann CE. RHEUMATIC HEART DISEASE IN PATIENTS OVER SIXTY YEARS OF AGE. JAMA. 1951;146(16):1474-1478. doi:10.1001/jama.1951.03670160016005