Which other cardiac manifestation may accompany rheumatic fever?

• A. Pericarditis
• B. Pulmonary Hypertension
• C. Atrial Fibrillation
• D. Myocardial Infarction

Answer: (A)

Rheumatic fever can involve multiple parts of the heart, not just the valves. In addition to valve inflammation, the pericardium can also become inflamed, leading to pericarditis. This makes pericarditis a recognized accompanying cardiac manifestation during the acute phase of rheumatic fever. The underlying mechanism is an immune response after a group A streptococcal infection that cross-reacts with heart tissues, causing inflammation across the heart layers.

Pulmonary hypertension, atrial fibrillation, and myocardial infarction are not typical acute features of rheumatic fever. Pulmonary hypertension tends to develop with long-standing valvular disease, atrial fibrillation is not usually seen in the acute stage unless there is significant atrial enlargement from chronic disease, and myocardial infarction is not a usual consequence of rheumatic fever.