Natural Course of Active Rheumatic Carditis and Evaluation of Hormone Therapy

• The course of rheumatic carditis in 100 patients treated with digitalis, salicylates, sedation, and symptomatic therapy was compared with its course in 55 patients treated with the hormones corticotropin, cortisone, and hydrocortisone. The three hormones were equally effective. In all patients so treated, the signs and symptoms of active carditis were arrested within 24 to 72 hours, and in the majority of patients enlarged chambers were reduced to normal and new precordial murmurs had regressed by the third to seventh day. A difference was found between the favorable results in the hormone-treated group and the protracted illness with residual cardiac damage seen in every patient in the contratest group. There was no overt evidence of residual damage in 84% of the patients who were having their first attack of carditis and who were treated with hormones.