الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Involvement of the heart is the most serious complication of rheunatic fever (RF) and occurs in about half of cases during the initial attack the cardnis of rheumatic fever is considered to be a pancarditis. Endocarditis is easy to be detected clinically and by echocardiography, whereas pericardits is primarily a clinical, electrocardiographic diagnosis and echocardiography is the diagnostic method of choice in detecting pericardial effusion, the diagnosis of myocarditis, particularly if mild may be somewhat difficult because no pathgnomonic tool for its diagnosis, cardiac troponin i (cTnl) is a newly available biochemical marker of myocardial lesions, cTnl is the actinomyocin ATPase-inhibiting subunit, is specific for cadiomyocyte damage and is not present in senjln of healthy individuals. therefore, its appearance in blood would be a clear signal of cardiac myocyte damage, The aim of the study is, to determine the extent of cardioinyocyte injury by cTnl and creatine kinase- MB (CK-MB) in the peak inflammatory process of active carditis. to unmask a potential myocardial factor in patients with RHD that may be related to low grade smouldering activity andlor mechanical factor imposed by valvular regurgitation, and to determine if there is ally correlation between the extent of endocarditis with the degree of cardiomyocyte injury if any in the acute inflammatory phase of the disease.