An evaluation of large doses of cortisone in first attacks of rheumatic carditis

Pediatrics

“…Though early clinical results indicate that salicylates, cortisone, and ACTH are reasonably comparable in efficacy (43), it is possible that cortisone may have a slight advantage in terms of residual cardiac damage. Several authors (44,45) leave the impression that initiation of cortisone in large doses within a week of onset, and continued over long periods, has been followed by disappearance of murmurs in a higher proportion of patients than would otherwise be expected-94 per cent or more. In most clinics, cortisone is considered a life-saving therapeutic agent in some patients with clinically severe and obviously progressive disease.…”

Pediatrics

“…In some cases favorable response to the administration of steroids early in the patient's clinical course, or in first attack of carditis, has suggested that the course of active carditis might be altered by decreasing both the severity and duration of the attack, and that in reducing the severity of acute ex acerbations, steroids might also be useful even in patients with chronic rheumatic carditis (43,44,45). This important subject is, however, still con troversial.…”