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(Circulation. 1972;45:543.)
© 1972 American Heart Association, Inc.

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Long-Term Prognosis of Rheumatic Fever Patients Receiving Regular Intramuscular Benzathine Penicillin

DOROTHY G. TOMPKINS M.D.¹; BERNARD BOXERBAUM M.D.¹; JEROME LIEBMAN M.D.¹

¹ From the Rainbow Rheumatic Fever Clinic, Babies and Childrens Hospital, and the Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio.

The prognosis for 115 rheumatic fever patients subsequently receiving regular intramuscular penicillin prophylaxis for at least 5 years was studied. Average follow-up was 9.3 years, and 57 patients were followed for 10 years or longer. Of the 79 patients with acute mitral regurgitation, 70% lost their murmur from 4 days to 8.5 years after it was first heard. This is in contrast to those with acute aortic regurgitation which persisted in 73%. No patient developed mitral or aortic stenosis: this suggests that regular prophylaxis may prevent the development of stenosis. Congestive failure, cardiomegaly, and arrhythmia correlated closely with persistence of murmurs, but increased P-R interval, acute QRS or T-voltage variation or both, and ST-T abnormalities did not.

Key Words: Rheumatic valvulitis • Rheumatic prophylaxis • Rheumatic heart disease

Submitted on November 6, 1970
Accepted on October 20, 1971

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