All of the following can occur in rheumatic fever except: September 2007, 2010

Ans. D: Loud first hea sound The mitral valve is almost always affected, sometimes together with the aoic valve; isolated aoic valve involvement is rare. Early valvular damage leads to regurgitation. Over ensuing years, usually as a result of recurrent episodes,leaflet thickening, scarring, calcification, and valvular stenosis may develop. Pericarditis may develop and commonly causes a friction rub. Myocardial inflammation leads to softening of first hea sound.