Diagnosis of primary chronic rheumatic carditis in adults.

The authors maintain that in some cases one can note the so-called primar chronic rheumatic carditis, or apparently primary rheumatic carditis. Streptococcal infections can be held responsible for the eventuality of a sub-clinical evolution of rheumatism, and there which develops as a clinical form of latent rheumatism, and there is the possibility of ulterior development of valvular cardiopathy without a clear history of acute rheumatic fever in the antecedents. One of the groups subjects with maximal exposure to repeated streptococcic infection is represented by the teaching personnel working permanently in school or pre-school children collectivities or with teen-agers, which are both carriers and disseminators of the rheumatogenic streptococcal infection. Of a total of 50 cases of apparently primary chronic valvular cardiopathies that have been followed by the ASCAR personnel, 48 had tonsillary infections in their antecedents, 8 had arthralgia and 4 cases were detected by chance. In school collectivities at high risk prophylaxis with penicillin should be mandatory, both for the students and for the teaching personnel.