Which cardiac involvement can occur with rheumatic fever?

• A. Endocarditis
• B. Myocardial Infarction
• C. Aortic Aneurysm
• D. Pulmonary Embolism

Answer: (A)

Rheumatic fever can cause inflammation of the heart in several layers, a process called pancarditis, with the endocardium most classically involved—targeting the heart valves (especially the mitral valve) and leading to valvulitis. This makes endocardial involvement the best answer here. The heart can also be affected by myocarditis and pericarditis, but the other choices aren’t typical direct cardiac manifestations of rheumatic fever: myocardial infarction comes from coronary artery disease, an aortic aneurysm is a vascular wall pathology, and a pulmonary embolism is a clot-related event. The underlying mechanism is an immune reaction after a streptococcal infection causing valve inflammation and potential long-term valve disease.