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From The Hygienic Dictionary
Diagnosis.  In the United States, making a diagnosis impli...
Endocarditis A Secondary Affection
Source: Disturbances Of The Heart
Mild endocarditis is rarely a primary affection, and is almost
invariably secondary to one of the diseases named above. Nearly 75
percent of secondary endocarditis occurs as a complication of acute
articular rheumatism and chorea, or subsequently. On the other hand,
about 40 percent of all patients with acute articular rheumatism
develop endocarditis, sometimes perhaps so mild as to be hardly
discoverable. This complication is most likely to occur during the
second or third week of rheumatic fever. It is not sufficiently
recognized that a subacute arthritis, recurring tonsillitis, open
and concealed infections in the mouth, and even a condition of the
system with acute, changeable and varying joint and muscle pains may
all develop a mild endocarditis, even with subsequent valvular
lesions. Therefore in all of these conditions the decision can be
made only as to how much rest the patient must have or how serious
the condition is to be considered by careful examination of the
heart in every instance.
Children are more liable than adults to this complication,
especially with rheumatism. Therefore, acute mild endocarditis with
future valvular lesions occurs most frequently during childhood and
adolescence, and if one attack has occurred, a subsequent infection,
especially of rheumatism, is liable to cause another acute
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