The beneficial effect of pituitary adrenocorticotropic hormone (ACTH) in rheumatic fever, first reported by Hench and associates1 in 1949, has been confirmed by several investigators.2 There has been general agreement that there is prompt subsidence of fever and arthritis. The effect in acute carditis has been difficult to evaluate. In most instances the patients selected for study had rheumatic fever with onset several weeks prior to therapy. In addition, treatment with the hormone was continued for four to six weeks in daily amounts of 20 to 50 mg.
We were fortunate to have 11 consecutive patients, 6 to 18 years of age, admitted to the New York Hospital3 with acute rheumatic carditis of relatively short duration. In six patients it was presumably an initial episode, and in five it was a recurrent attack.
Pituitary adrenocorticotropic hormone was given intramuscularly in a daily amount of 30 to 100