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August 18, 1945

THE RELATIONSHIP OF POSTSCARLATINAL ARTHRITIS AND CARDITIS TO RHEUMATIC FEVER

JAMA. 1945;128(16):1145-1152. doi:10.1001/jama.1945.02860330013004
Abstract

Our purpose in this communication is to present the evidence of cardiac involvement occurring among 110 patients with scarlet fever and to correlate this involvement with rheumatic fever.

Cardiac injury, often associated with arthritis, has long been known to follow scarlet fever, but there still exists some question of its relationship to rheumatic fever. The cardiac and joint sequelae are still commonly designated as postscarlatinal carditis and arthritis without reference to this possible relationship. Many workers, on the other hand, have stressed the apparent close connection between postscarlatinal and rheumatic heart disease.1

It is well known that electrocardiographic abnormalities comparable to those seen in active rheumatic fever also occur during both the acute and the convalescent stage of scarlet fever. The reported incidence of such abnormalities has varied much, reaching as high as 86 per cent in the cases examined by Wickström.2 This variation is in part due

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