Disease of the heart valves following an episode of rheumatic fever. The valves commonly involved are:

  • Mitral valve, leading to stenosis, incompetence, or both
  • Aortic valve, leading to stenosis and incompetence or both

Clinical features

  • Heart failure
  • Arrhythmias, palpitations
  • Thromboembolic problems e.g. stroke
  • Heart murmurs depending on valves affected and nature of effect caused
  • The patient may be asymptomatic and the valvular lesion discovered as an incidental finding
  • Increased cardiac demand as in pregnancy and anaemia may present as congestive cardiac failure

Differential diagnosis

  • Other causes of cardiac failure


  • Chest X-ray
  • ECG where available
  • Echocardiography


  • Treat heart failure if present
  • Prophylaxis for life as in rheumatic fever
  • Cardiac surgery if necessary