日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

We report a rare case of sudden cardiac death associated with acute rheumatic fever (ARF). The patient was a 12-year-old boy referred to our hospital because of sudden cardiopulmonary arrest. Resuscitation failed and autopsy was performed. Pathological findings revealed diffuse pancarditis, which was prominent in the conduction systems, particularly around the atrioventricular node and disseminated Aschoff bodies in various parts, including the valves, myocardium, and endocardium. These findings strongly suggested that his death was caused by atrioventricular block associated with ARF. Although ARF is a common disease in developing countries, it is rare in Japan, with the reported annual incidence of 4–10 cases a year. ARF should be considered in the differential diagnosis of febrile illnesses, particularly in the era when routine antibiotic administration is not recommended.