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The Pattern of Symptoms, Pre-Treatment Interval, and Prognosis of Acute Rheumatic Fever

ALVAN R. FEINSTEIN, M.D.; JUANITA G. ZAGALA, M.D.; and MARIO SPAGNUOLO, M.D.
Ann Intern Med. 1962;57(4):563-571. doi:10.7326/0003-4819-57-4-563
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In a recent re-appraisal of the clinical patterns of acute rheumatic fever (1), we decided to examine the now traditional belief that residual heart disease is prevented by early treatment. Inspected grossly, the data for first attacks of rheumatic fever showed residual heart disease in 53 (25 per cent) of 209 patients who began treatment within the first 2 weeks after onset of symptoms and in 38 (69 per cent) of 55 patients who began treatment after the first 2 weeks. This highly significant difference seemed to be a clear demonstration that early treatment was of definite value.

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