I really had no idea of the exact symptoms of rheumatic fever, so I looked it up. It's awful. :-(
The acute attacks begin one to four weeks after a strep throat. Doctors know that the streptococci do not migrate in the body to cause the attack of rheumatic fever, but they do not know how the bacteria set off the inflammatory reaction that occurs. Because no laboratory tests are specific for rheumatic fever, doctors rely on a medical history, a physical examination and a classification scheme to diagnose it.
According to the scheme, known as the Jones criteria, there are five major and three minor indications.
The major ones are: inflammation of the heart; arthritis; a syndrome involving involuntary jerky movements of the body, halting and slurred speech and facial grimaces, known as chorea, that disappear in a few weeks with no permanent damage; a rash that does not itch, and bumps under the skin.
The minor indications are fever, joint pains and a history of previous attacks of rheumatic fever. The presence of two major, or one major and two minor manifestations signals a high likelihood of rheumatic fever.
In a typical attack, rheumatic fever causes inflammation and swelling of the joints that is intensely painful for a few days; the pain abates over the next week as the swelling subsides. The usual targets are joints in the legs, particularly the knees, but the swelling and other symptoms often migrate from joint to joint.
Rheumatic fever does not permanently damage joints, but it can cause immediate fatal damage to the heart muscle, or it can produce long-term lethal effects by scarring valves. Damaged valves either restrict the blood flow or create severe leaks that strain the heart. When the scarring interferes with the opening and closing of the valves, it causes murmurs audible through a stethoscope. The scarred valves may require surgical repair or replacement.
Rheumatic fever was one of the most common diseases in America through the 1940's. In World War II, the rate reached 388 per 100,000 in some Army camps. The disease's decline began thereafter. By the mid-1960's, it affected about only 30 per 100,000 school children in mid-sized American cities. In surveys in the last few years, the rates were about 1 per 100,000. A similar decline occurred in Canada and Europe.
No wonder she had to give up her career as a dancer. How sad for her.