Key result
A 13-year-old girl with recurrent acute rheumatic fever developed a rare quadrivalvular rheumatic heart disease and an atrial septal defect, ultimately dying from cardiogenic shock.
Case Report (n=1)
This case highlights the severe, fatal impact of late-presentation quadrivalvular rheumatic heart disease in a child and underscores the urgent need for primary and secondary RHD prevention programs in developing regions.
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Alerts clinicians to rare multivalvular complications in recurrent rheumatic fever; leaves open questions on prevention in endemic regions.
Rheumatic heart disease (RHD) is the most common cause of acquired heart disease in children and young adults in developing countries. It results from throat infection with group A beta hemolytic streptococcus that proceeds to acute rheumatic fever (ARF). We report a 13 years old girl from Darfur presenting with recurrent acute rheumatic fever for 4 years that led to affection of all her heart valves with severe mitral and tricuspid regurgitation together with moderate pulmonary and mild aortic valve regurgitation. There was an associated atrial septal defect (Lutembacher syndrome variant). The disease was severe and led to cardiogenic shock and death while awaiting surgery. The case highlights the impact of RHD on young people and the need to implement control programs for RHD in Sudan.
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Karadawi et al. (2017) conducted a case report in Rheumatic heart disease (Lutembacher syndrome variant) (n=1). Recurrent acute rheumatic fever was evaluated on Clinical outcome. A 13-year-old girl with recurrent acute rheumatic fever developed a rare quadrivalvular rheumatic heart disease and an atrial septal defect, ultimately dying from cardiogenic shock.
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