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
Investigations
- Chest X-ray
- ECG where available
- Echocardiography
Management
- Treat heart failure if present
- Prophylaxis for life as in rheumatic fever
- Cardiac surgery if necessary