Rheumatic heart disease manifesting as mitral stenosis and tricuspid regurgitation in a young Asian male: a case report.

Abstract

Background: Rheumatic heart disease (RHD) is a major global health issue because of its potential to cause heart failure. While RHD has been reported more frequently in women, this case report highlights the clinical manifestations, diagnosis, and management of rheumatic multivalvular disease in a young Asian male.

Case summary: A 46-year-old Asian man with a history of percutaneous mitral valvuloplasty (PMV) was admitted with dyspnoea and generalized oedema that severely hindered his quality of life. Transthoracic and transoesophageal echocardiography revealed severe mitral stenosis, left atrial appendage (LAA) thrombus, and severe tricuspid regurgitation due to RHD. Following a comprehensive evaluation by a multidisciplinary team, we advised mitral valve replacement, LAA thrombectomy, and tricuspid valve annuloplasty based on the detailed imaging of the valve anatomy and the patient's low surgical risk. Surgical intervention led to considerable improvement in the patient's symptoms, enabling a return to routine activities.

Discussion: This case highlights the chronic nature of RHD and its potential to cause heart failure. This report emphasizes the need for regular follow-up in patients with a history of RHD to detect potential complications and ensure timely management. The successful outcome in this case underscores the importance of a team-based approach for managing complex valvular heart disease.