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Fulminant mitral regurgitation due to ruptured chordae tendinae in acute rheumatic fever

Yvonne Anderson1, Nigel Wilson, Ross Nicholson

  • 1Kidz First Children's Hospital, Middlemore Hospital, South Auckland, New Zealand.

Journal of Paediatrics and Child Health
|September 15, 2007
PubMed

Insights

Fulminant mitral regurgitation in acute rheumatic fever (ARF) can cause severe heart failure in children. Urgent cardiac surgery for mitral valve repair can be life-saving in these critical cases.

Area of Science:

  • Pediatric Cardiology
  • Rheumatic Heart Disease
  • Cardiac Surgery

Background:

  • Acute rheumatic fever (ARF) can present with severe, life-threatening cardiac complications.
  • Fulminant mitral regurgitation, characterized by ruptured chordae tendinae and flail mitral leaflets, is an uncommon but critical manifestation of ARF.

Purpose of the Study:

  • To describe the presentation and management of children with fulminant mitral regurgitation secondary to ARF.
  • To highlight the diagnostic and therapeutic challenges associated with this rare condition.

Main Methods:

  • A retrospective case series involving four pediatric patients (aged 6-10 years) who presented with acute pulmonary edema.
  • Evaluation of patients with severe mitral regurgitation due to chordae tendinae rupture and flail mitral leaflets.

Main Results:

  • All four patients underwent urgent cardiac surgery with successful mitral valve repair.
  • Complete resolution of heart failure symptoms was achieved in all cases post-operatively.
  • The study underscores the difficulties in diagnosing and managing this uncommon ARF presentation.

Conclusions:

  • Cardiac surgery, specifically mitral valve repair, is a life-saving intervention for fulminant mitral regurgitation in the context of ARF.
  • Early recognition and surgical management are crucial for favorable outcomes in pediatric patients with this severe presentation.
Abstract

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