Rheumatic Heart Disease (RHD) Acute(Pancarditis In rheumatic fever, any layer of the heart can be involved, including endocarditis, myocarditis and pericarditis. All three basic changes can be observed Chronic Characterized by repeated inflammation with fibrinous resolution, result in severe anatomic change of valves, include leaflet thickening, commissural fusion and shortening and thickening of the tendinous cordsRheumatic Heart Disease (RHD) ◼ Acute (Pancarditis) In rheumatic fever, any layer of the heart can be involved, including endocarditis, myocarditis and pericarditis. All three basic changes can be observed. ◼ Chronic Characterized by repeated inflammation with fibrinous resolution, result in severe anatomic change of valves, include leaflet thickening, commissural fusion and shortening and thickening of the tendinous cords