Last reviewed 01/2018

Chronic rheumatic heart disease develops in about 50% of patients with carditis. It is more likely:

  • when the initial attack occurs in childhood
  • when the initial attack of rheumatic fever was severe
  • with recurrent attacks

Mitral stenosis is the most common outcome, followed by aortic stenosis. The tricuspid and pulmonary valves are rarely affected. Untreated, chronic valvular deformity usually results in eventual cardiac failure.

Recurrence of rheumatic fever may be precipitated by future streptococcal infection. Chorea may return with use of the contraceptive pill or pregnancy.