The Association of Rheumatic Fever and Cardiovascular Diseases

When did people first notice that people with rheumatic fever often developed heart disease and specifically this association with the cardiac valves? So it was a really, really long time ago actually. In 1832, a British physician named James Hope, who some considered to actually be the first cardiologist in the modern sense, wrote a book called a Trio T's of the Diseases of the Heart and Great Vessels. He made this connection between rheumatism, presumably from streptococcal infection in retrospect and valvular damage as evidenced by this bellows murmur that he heard on exam.