Affiliation:
1. Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
Abstract
Four-valve involvement (mitral, aortic, tricuspid, and pulmonary) in rheumatic heart disease (RHD) is an exceedingly rare entity. We report the case of a 24-year-old male, a known case of RHD, who presented with dyspnea and presyncope for 2 months. On examination, the patient had severe mitral stenosis, moderate mitral regurgitation, severe aortic stenosis, severe aortic regurgitation, and severe tricuspid regurgitation. Echocardiography revealed severe tricuspid stenosis with moderate pulmonary stenosis in addition to other clinically detectable valve lesions. The patient underwent aortic and mitral valve replacement, tricuspid valve repair with pulmonary valvotomy successfully.