In rheumatic heart disease, the most common valve lesion in adults from recurrent rheumatic fever is mitral stenosis. The pathognomonic histological finding of active rheumatic carditis is:

• A Aschoff nodules — perivascular granulomas with central fibrinoid necrosis and Anitschkow cells (caterpillar cells) ✓
• B Fibrinous pericarditis with haemorrhagic effusion
• C Non-caseating granulomas with giant cells in myocardium
• D Eosinophilic myocarditis with diffuse eosinophil infiltration

Explanation

Aschoff nodules are the pathognomonic lesion of rheumatic carditis — foci of granulomatous inflammation with central fibrinoid necrosis, surrounded by lymphocytes, macrophages, and characteristic Anitschkow cells (modified macrophages with caterpillar/owl-eye nuclei, also called Anitschkow myocytes). They are found predominantly in the myocardium and appear during the acute phase. Non-caseating granulomas are characteristic of sarcoidosis. Eosinophilic myocarditis is drug-induced or parasitic.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.