Pancarditis in rheumatic fever involves which heart layers?

Pancarditis in rheumatic fever involves which heart layers?

• A. Endocardium only
• B. Myocardium only
• C. Pericardium only
• D. All heart layers

Answer: (D)

Rheumatic fever can trigger inflammation that touches every part of the heart, so it is described as pancarditis. The endocardium is inflamed with involvement of the valve leaflets and subvalvular apparatus, often leading to verrucous endocarditis and later valvular disease. The myocardium develops focal granulomatous inflammation (Aschoff bodies with Anitschkow cells), causing myocarditis that can weaken contraction and provoke arrhythmias or heart failure in the acute phase. The pericardium also becomes inflamed, producing fibrinous pericarditis with a possible friction rub. Because the inflammatory process can involve all three layers simultaneously, all heart layers are affected.

Rheumatic fever can trigger inflammation that touches every part of the heart, so it is described as pancarditis. The endocardium is inflamed with involvement of the valve leaflets and subvalvular apparatus, often leading to verrucous endocarditis and later valvular disease. The myocardium develops focal granulomatous inflammation (Aschoff bodies with Anitschkow cells), causing myocarditis that can weaken contraction and provoke arrhythmias or heart failure in the acute phase. The pericardium also becomes inflamed, producing fibrinous pericarditis with a possible friction rub. Because the inflammatory process can involve all three layers simultaneously, all heart layers are affected.