This case report highlights the successful surgical management of severe trivalvular rheumatic heart disease and discusses the disparities in care between developed and developing nations.
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Supports feasibility of multivalve surgery in severe rheumatic heart disease; leaves open questions on long-term durability and equitable access.
A 42-year-old woman who had recently emigrated to the UK from Ethiopia presented to her general practitioner with increasing breathlessness and palpitations. Transoesophageal echocardiogram revealed rheumatic heart disease affecting three valves, and severe aortic stenosis. ECG demonstrated atrial fibrillation. She was treated operatively with mitral and aortic valve replacement and tricuspid valve repair and put on lifelong warfarin. Four months later she remains well, with substantially increased exercise tolerance. This case report summarises treatment options for severe rheumatic heart disease and discusses differences in prevention and management between patients presenting in the UK and in the developing world.
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Kelly et al. (2014) studied this question.
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