Rheumatic heart disease with triple valve involvement
1,Università degli studi di Milano Facoltà di medicina e chirurgia
2Emergency department, IRCCS Policlinico
DOI: 10.22514/SV91.042014.9 Vol.9,Issue 1,April 2014 pp.50-52
Published: 30 April 2014
Acute rheumatic fever (ARF) is a postinfectious, nonsuppurative sequela of pharyngeal infection caused by Streptococcus pyogenes, or Group A β hemolytic Streptococcus (GABHS). Of the associated symptoms, only damage to the heart’s valvular tissue, or rheumatic heart disease (RHD), can become a chronic condition leading to congestive heart failure, stroke, endocarditis, and death. ARF is the most common cause of cardiac disease in children in developing countries. A joint meeting of the World Health Organization and the International Society estimated that 12 million people in developing countries were affected by acute rheumatic fever and rheumatic heart disease, with the majority of these being children. This level of morbidity is comparable to developed countries’ in the last century, before an increase in the standard of living and the introduction of penicillin. Significant trivalvular disease, involving the mitral, aortic and tricuspid valves, is uncommon. Although rare, trivalvular disease has been described in the literature. Clinical and hemodynamic manifestations depend on the severity of each lesion. We reported this case because of the rare presentation of an uncommon disorder and to highlight the fact that the presence of trivalvular disease can be difficult to diagnose, even for a trained physician.
rheumatic heart disease, triple valve disease, rheumatic valve disease
MATTEO BRAMBATI,FIORANGELA MARLETTA,GIORGIA MANINA,DENISE PROVVIDENZA COMINA,NGAMBE MANDI PRESTON,'GIUSEPPINA CASSETTI,CHIARA MERLO,MICHELE VOLPI,ROBERTA MUSSO,PIER FRANCESCO LAURENZI,ROBERTO LA ROCCA. Rheumatic heart disease with triple valve involvement. Signa Vitae. 2014. 9(1);50-52.
1. Kumar R. Controlling rheumatic heart disease in developing countries. World Health Forum 1995;16:47–51.
2. Hameed AB, Tummala PP, Goodwin TM, Nuno I, Wani OR, Karaalp IS, et al. Valvular disease in pregnancy: Effects on maternal and fetal outcome. Circulation 1999;100:1-148.
3. Gash AK, Carabello BA, Kent RL, Frazier JA, Spann JF. Left ventricular performance in patients with coexistent mitral stenosis and aortic insufficiency. J Am Coll Cardiol 1984;3:703.
4. Cunningham MW. Pathogenesis of group A streptococcal infections. Clin Microbiol Rev 2000;13:470–511.
5. Fawzy ME, Osman A, Nambiar V, Nowayhed O, Badr A, Canver CC. Immediate and long-term results of mitral balloon valvuloplasty in patients with severe pulmonary hypertension. J Heart Valve Dis 2008 Sep;17(5):485-91.
6. Song JM, Kang DH, Song JK, Jeong YH, Lee CW, Hong MK, et al. Outcome of significant functional tricuspid regurgitation after percuta-neous mitral valvuloplasty. Am Heart J 2003 Feb;145(2):371-6.
7. Sagie A, Freitas N, Chen MH, Marshall JE, Weyman AE, Levine RA. Echocardiographic assessment of mitral stenosis and its associated valvular lesions in 205 patients and lack of association with mitral valve prolapse. J Am Soc Echocardiogr 1997 Mar;10(2):141-8.
8. Kim HK, Kim YJ, Kim KI, Jo SH, Kim KB, Ahn H, et al. Impact of the maze operation combined with left-sided valve surgery on the change in tricuspid regurgitation over time. Circulation 2005 Aug 30;112(9 Suppl):I14-9.
9. Jones TD. Diagnosis of rheumatic fever. JAMA 1944;126:481–4.
10. Coll-Mazzei JV, Jegaden O, Janody P, Rumolo A, Bonnefoy JY, Mikaeloff P. Results of triple valve replacement: perioperative mortality and long term results. J Cardiovasc Surg 1987 Jul-Aug;28(4):369-73.
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