system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
All of the following can occur in rheumatic fever except: September 2007, 2010
assistant
The correct answer is  Ans. D: Loud first hea sound The mitral valve is almost always affected, sometimes together with the aoic valve; isolated aoic valve involvement is rare. Early valvular damage leads to regurgitation. Over ensuing years, usually as a result of recurrent episodes,leaflet thickening, scarring, calcification, and valvular stenosis may develop. Pericarditis may develop and commonly causes a friction rub. Myocardial inflammation leads to softening of first hea sound.