Orris

Recurrence remission and one more R in RHD

In Rheumatic Heart Disease (RHD), the classic three R's are:
  1. Recurrence - of acute rheumatic fever (ARF) episodes
  2. Remission - of the active carditis/inflammation
  3. Residue - the permanent valvular damage left behind after the acute episode
Residue is the third R - referring to the chronic, irreversible valvular lesions (most commonly mitral stenosis) that remain as a sequela of repeated rheumatic fever attacks, even after the acute inflammation has settled.
Some sources also cite Reactivation as an alternative third R, but Residue is the most widely accepted term in standard teaching for the permanent structural cardiac damage characteristic of RHD.
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