Acute rheumatic fever can involve the heart directly, producing carditis ranging in severity from mild to life-threatening. When carditis is severe enough to cause heart failure, the clinical picture requires specific management beyond standard anti-inflammatory therapy.
This protocol addresses patients with acute rheumatic fever who present with carditis or heart failure. Treatment of heart failure may be required in severe, acute carditis. Corticosteroids are specifically indicated for severe carditis or pericarditis with effusion.
In patients with severe carditis causing heart failure where acute cardiac surgery is not indicated, additional anti-inflammatory therapy becomes necessary. Corticosteroid therapy forms a key component of management in this setting — the complete regimen, including agent selection and route of administration for very severe presentations, is detailed in the full protocol.