The place of cortisone and related hormones in the treatment of acute rheumatic fever, including acute rheumatic carditis, remains controversial. Some persons consider these hormones to exert no more effect than salicylates in such cases.1 However, a considerable number of experienced clinicians hold that the use of cortisone-like hormones is the most effective measure presently available for suppression of the rheumatic inflammatory reaction in the heart and hence is indicated in the treatment of acute rheumatic fever.2
Congestive heart failure in rheumatic fever can be attributed to one or more of at least three factors: (1) reversible weakening of the myocardium from the rheumatic inflammatory process (rheumatic myocarditis), (2) excess strain on the heart muscle from damaged valves, and (3) irreversible changes in cardiac muscle secondary to rheumatic inflammation. The cortisone-like hormones are considered to relieve congestive failure in active rheumatic carditis by means of their suppressive effect
USE OF CORTISONE IN RHEUMATIC CARDITIS WITH CONGESTIVE HEART FAILURE. JAMA. 1955;159(3):196. doi:10.1001/jama.1955.02960200042009
Customize your JAMA Network experience by selecting one or more topics from the list below.