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Beyond rheumatic: therapeutic implications in mitral regurgitation

Published online by Cambridge University Press:  01 August 2025

Nisanth Selvam Open the ORCID record for Nisanth Selvam [Opens in a new window] ,
Kelsey Brown ,
Yonairy C. Puello ,
Navaneetha Sasikumar  and
Scott Wirth
Nisanth Selvam
Affiliation:
Department of Paediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, KL, India
Kelsey Brown
Affiliation:
Department of Paediatric Cardiology, Children’s National Hospital, Washington, DC, USA
Yonairy C. Puello
Affiliation:
Department of Paediatric Cardiology, Children’s National Hospital, Washington, DC, USA
Navaneetha Sasikumar*
Affiliation:
Department of Paediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, KL, India
Scott Wirth
Affiliation:
Cincinnati Children’s Hospital Medical Center, Heart Institute, Cincinnati, OH, USA
*
Corresponding author: Navaneetha Sasikumar; Email: drnavni@yahoo.com
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Abstract

The dominant focus on rheumatic aetiology of mitral regurgitation (MR) often overshadows other causes. This challenges optimal management when the aetiology is non-rheumatic, as exemplified below in an 8-year-old girl, hailing from Uganda, who was diagnosed and managed as rheumatic MR with unusually elevated and persistent systemic inflammatory state with chronic renal dysfunction disproportionate to her cardiac status. Further workup led towards the possibility of early onset systemic lupus erythematosus (SLE). The valvular involvement in SLE closely resembles rheumatic heart disease (RHD). A high level of clinical suspicion is essential for diagnosing childhood-onset SLE. Coexistence of RHD and SLE is extremely rare and has significant implications for management.

Keywords

Rheumatic heart diseasemitral regurgitationsystemic lupus erythematosus

Information

Type
Case Report
Information
Cardiology in the Young , First View , pp. 1 - 5
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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References

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