ABSTRACT
Rheumatic heart disease continues to be a cause of concern in the developing countries. In India it is a major public health challenge which contributes to high morbidity and mortality. Acute rheumatic fever is an inflammatory, recurrent, nonsuppurative disease which follows pharyngitis caused by group A beta-hemolytic streptococci. It is most often observed in acute rheumatic carditis. Both layers of the pericardium are thickened and covered with varying amounts of fibrin that project between the two layers. Mechanism of formation of vegetations is possibly related to injury to the endocardium and exposure of the subendocardial connective tissues caused by the hemodynamic stress and strain on the valves. Rheumatic vegetations on cardiac valves from autopsied cases of acute rheumatic carditis were evaluated by scanning electron microscopy. Scanning electron micrograph of vegetations on the mitral valve in a case of acute rheumatic fever.
