Treatment choice inacuterheumatic carditis

SUMMARY A trial was conducted using sequential analysis bypairs tocompare theefficacy of corticosteroids andsalicylates inthetreatmentofacuterheumatic carditis. Theresults showa significantly favourable effect ofsteroid treatmentbothinclinical responseandinreduction of theerythrocyte sedimentation rate.Inaddition, patients receiving steroids usually hada shorter hospital stay.Theuse ofsteroids inacuterheumatic feverwithcarditis isrecommended. Whilethedecline inrheumatic fever andrheumatic heartdisease isa phenomenonofthedeveloped world,inAfrica andAsiathedisease isstill an important causeofmortality andmorbidity.t The placeofcorticosteroids inthetreatment ofacute rheumatic carditis remainsunclear despite more than20yearsofuseinclinical practice. Most authorities now endorsetheuseofsteroids in patients withmoderateto severecarditis,2 4 although somestill claim that steroids havenoplace inthetreatment ofacuterheumatic carditis.5 This studywasdesigned tocomparetheefficacy of steroids andsalicylates inthemanagement ofacute rheumatic carditis. Patients andmethods Allchildren presenting totheRed CrossWar Memorial Children's Hospital withfeatures ofacute rheumatic fever werereferred toamemberofthe cardiology unit. Thosepatients fulfilling thefollowingcriteria wereincluded inthestudy: