A tale of two valves: where rheumatic mitral disease meets aortic papillary fibroelastoma – a narrative review

Rheumatic heart disease (RHD) and papillary fibroelastoma (PFE) are distinct cardiovascular disorders that can rarely occur together. RHD is a chronic condition caused by untreated streptococcal infections, primarily affecting the mitral valve and resulting in severe valvular damage. On the other hand, PFE is a benign heart tumor, usually affecting the aortic valve, and is typically asymptomatic, often discovered incidentally through imaging. The simultaneous presence of RHD and PFE, especially involving the mitral and aortic valves, has only been reported in two case studies. This review examines the pathophysiology, clinical features, diagnostic challenges, and treatment options for both conditions. Echocardiography is the primary diagnostic tool, and surgery, involving tumor removal and valve replacement, is the standard treatment for symptomatic cases. Although this dual condition is rare, the review highlights the significance of early detection, particularly in areas where RHD is common, and calls for additional research to explore the potential connections between these conditions and improve patient care.