In rheumatic heart disease, which valve is most commonly affected?

In rheumatic heart disease, which valve is most commonly affected?

• A. Pulmonary Valve (PV)
• B. Tricuspid Valve (TV)
• C. Aortic Valve (AOV)
• D. Mitral Valve (MV)

Answer: (D)

Rheumatic heart disease most commonly targets the mitral valve. After a streptococcal infection, an immune-mediated inflammatory process preferentially involves the left-sided valves, with the mitral valve bearing the brunt due to the higher pressures and its complex architecture. Over time this leads to leaflet thickening, commissural fusion, and chordae shortening, producing mitral stenosis (the classic chronic lesion) and sometimes regurgitation. The aortic valve is the next most commonly affected, while the tricuspid and pulmonary valves are less commonly involved. Clinically, mitral involvement often presents with features of mitral stenosis, such as a diastolic murmur and, on auscultation, an opening snap.

Rheumatic heart disease most commonly targets the mitral valve. After a streptococcal infection, an immune-mediated inflammatory process preferentially involves the left-sided valves, with the mitral valve bearing the brunt due to the higher pressures and its complex architecture. Over time this leads to leaflet thickening, commissural fusion, and chordae shortening, producing mitral stenosis (the classic chronic lesion) and sometimes regurgitation. The aortic valve is the next most commonly affected, while the tricuspid and pulmonary valves are less commonly involved. Clinically, mitral involvement often presents with features of mitral stenosis, such as a diastolic murmur and, on auscultation, an opening snap.