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Youngest documented rheumatic mitral stenosis with regurgitation in a 28-month-old girl

Santosh Kumar Sinha1, Mohammad Asif2, Vikas Mishra2

  • 1Associate Professor, Department of Cardiology, Ganesh Shankar Vidyarthi Memorial Medical College, LPS Institute of Cardiology, Kanpur, Uttar Pradesh, India.

ARYA Atherosclerosis
|March 25, 2020
PubMed

Insights

Acute rheumatic fever (ARF) can affect very young children, leading to severe rheumatic heart disease (RHD). This case report details the youngest patient with mitral stenosis (MS) following ARF, emphasizing the need for early prevention.

Area of Science:

  • Pediatric Cardiology
  • Rheumatology
  • Global Health

Background:

  • Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are major causes of acquired heart disease in developing nations.
  • Rheumatic fever (RF) typically affects children aged 5-15, with rare occurrences in those younger than 5.
  • Mitral stenosis (MS) is the most frequent complication, and India sees rapid progression to severe MS in some ARF cases.

Observation:

  • A 28-month-old girl presented with severe mitral stenosis (MS), mitral regurgitation (MR), and pulmonary hypertension (PH).
  • These cardiac conditions were sequelae of an acute rheumatic fever (ARF) episode experienced at 18 months of age.

Findings:

  • This represents the youngest reported case of rheumatic mitral stenosis (MS) following acute rheumatic fever (ARF) in the literature.
  • The case challenges the prior belief that very young children (<5 years) are immune to ARF.

Implications:

  • Highlights the susceptibility of the very young population to ARF and its cardiac sequelae.
  • Emphasizes the need for more stringent preventive measures against ARF.
  • Suggests considering ARF in the differential diagnosis of carditis in young children.
Abstract

Keywords:
Acute Rheumatic FeverMitral RegurgitationMitral StenosisPulmonary Hypertension

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