That congestive failure in children with rheumatic heart disease is due to the presence of active rheumatic fever is now commonly recognized. Less well known, however, are the clinical features of heart failure in such patients. It is the purpose of this communication to describe these clinical features.
More than 200 children and adults with congestive failure and rheumatic heart disease have been carefully observed and treated at the House of the Good Samaritan between 1920 and 1940. Of particular interest for this report are 44 members of the group who entered the hospital during the period from July 1, 1937 to April 1, 1940, who were subjects of special study. These 44 patients were between the ages of 3 and 15 years (average, 8.8 years). The length of the stay in the hospital varied from less than a month to four years (average, twelve months).