Physical Activities and Rheumatic Heart Disease in Asymptomatic Patients

The influence of physical activity on the progression of rheumatic heart disease has been studied in 216 patients who were followed for an average of 21 years after an attack of acute rheumatic fever. The objective cardiac status became worse in 26 (12%), better in 50 (23%), and unchanged in 140 (65%) of the entire group. These percentages remained essentially the same when patients were divided according to the presence or absence of restrictions during school, outside of school, or in later postscholastic life. Although physical restrictions brought no cardiac benefits to asymptomatic patients, one significant effect was apparent: adverse psychosocial reactions developed in 34% of the 141 patients who were restricted in school activities, but only in 6% of the 75 who were unrestricted.