Rupture of tendinous chords during acute rheumatic carditis in young children

Area of Science:

• Pediatric Cardiology
• Rheumatology
• Cardiac Surgery

Background:

• Rupture of tendinous chords leading to acute mitral regurgitation is uncommon in children.
• Acute rheumatic carditis is a potential, though rare, etiology for this severe cardiac event.

Purpose of the Study:

• To report on a series of pediatric cases with acute mitral regurgitation caused by ruptured tendinous chords.
• To emphasize the role of acute rheumatic carditis as an underlying cause.
• To discuss the diagnostic and management complexities associated with this condition in young patients.

Main Methods:

• Case series involving four children aged 2 3/4 to 6 1/2 years.
• Clinical presentation, echocardiographic findings, surgical intervention (mitral valve replacement), and histological examination were analyzed.

Main Results:

• All four children presented with acute mitral regurgitation due to ruptured tendinous chords.
• Urgent mitral valve replacement was necessary for all patients.
• Histological examination confirmed acute rheumatic carditis as the cause in every case.

Conclusions:

• Acute rheumatic carditis is a rare but significant cause of mitral valve chord rupture in young children.
• Early diagnosis and prompt surgical management are crucial for favorable outcomes.
• The condition presents unique challenges in pediatric care.