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In addition, mitral plus either aortic or tricuspid lesions are usually secondary to rheumatic fever.
In contrast to the previous literature, we have analyzed specifically the presence of congenital cardiac malformations in patients with proven rheumatic heart disease.
Susceptibility to rheumatic fever have been ascertained because of the poor quality of records in earlier years.
These two categories often reach significant proportions, being several times the registered rates for acute rheumatic fever and chronic rheumatic heart disease.
This suggests excess mortality from rheumatic heart disease.
The cumulative incidence of acute rheumatic fever estimates the proportion of susceptible individuals in endemically exposed populations.
Either of these exceptions occurring as isolated manifestations establish rheumatic etiology without accompanying major or minor manifestations.
The other manifestations of acute rheumatic fever besides carditis usually disappear without sequels.
Because of the severe cardiac impairment produced by the disease, all efforts to include prophylaxis for rheumatic fever in public health programs are justified.
It is of note that, although streptococcal infections are very frequent, only a few individuals develop rheumatic fever.
With such high rates of streptococcal acquisition it is possible that most susceptible people will eventually develop rheumatic fever.
The statistical analysis suggests that a congenital lesion involving the pulmonary valve predisposes it to attack by the acute rheumatic process.
The rates for acute rheumatic fever are very low in relation to the expected figures considering their proportion of poverty.
The authors suggested that this procedure may he helpful in diagnosing and defining treatment for some cases of acute rheumatic carditis.
Of these, 8,100 were attributed to acute rheumatic fever and 61,002 to chronic disease, totalling 69,102 (or 1.08% of all deaths due to cardiovascular disease).