In rheumatic fever, tissue injury within the cusps or tendinous cords is characterized by which process?

In rheumatic fever, tissue injury within the cusps or tendinous cords is characterized by which process?

• A. Calcification
• B. Fatty degeneration
• C. Fibrosis
• D. Fibrinoid necrosis

Answer: (D)

The tissue injury described in acute rheumatic fever affecting the valve cusps and chordae tendineae is best described as fibrinoid necrosis. This immune-mediated damage features deposition of fibrin-like material and immune complexes in the endocardium, producing a bright, eosinophilic, amorphous area with surrounding inflammatory cells. It is the characteristic histologic change of acute rheumatic valvulitis, often with small vegetations along the lines of valve closure. Over time, healing can lead to fibrosis and scarring, but the immediate injury in the valves is fibrinoid necrosis. Calcification and fatty degeneration are not typical acute features of this process, and fibrosis represents later sequelae rather than the primary lesion described here.

The tissue injury described in acute rheumatic fever affecting the valve cusps and chordae tendineae is best described as fibrinoid necrosis. This immune-mediated damage features deposition of fibrin-like material and immune complexes in the endocardium, producing a bright, eosinophilic, amorphous area with surrounding inflammatory cells. It is the characteristic histologic change of acute rheumatic valvulitis, often with small vegetations along the lines of valve closure.

Over time, healing can lead to fibrosis and scarring, but the immediate injury in the valves is fibrinoid necrosis. Calcification and fatty degeneration are not typical acute features of this process, and fibrosis represents later sequelae rather than the primary lesion described here.