Rheumatic heart disease.

Morphology:

Pericarditis: fibrinous exudate
Myocarditis:
Fibrinoid necrosis with granuloma formation( Aschoff bodies) and giant cells known as Anitshcow giant cells
Endocaritis:
Verrucous; ie with small vegetations
Mitral and aortic valves are commonly involved in acute RF
Aschoff bodies can be found in subcutaneous nodules also
The endocardial lesions predispose to infective endocarditis


RHD Manifestations:

mitral valve 40-50%, MS>MR

aortic valve 15-20%,

mitral and aortic valves 35-40%,

mitral, aortic and tricuspid valves 2-3%

Verrucae along lines of closure of leaflets with fibrinoid necrosis and fibrosis.



Aschoff nodule in rheumatic heart disease.



Aschoff nodule in rheumatic heart disease. These are often in perivascular connective tissue rather than the myocardium.


Mitral rheumatic heart disease. Verrucae along lines of closure and thickened
chordae tendineae.



Rheumatic pericarditis – a diffuse fibrinous exudate on the epicardial surface.

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