Rheumatic disease is most likely the cause if both MS and AS are present.

Rheumatic disease is most likely the cause if both MS and AS are present.

• A. MS and AS
• B. GS and TS
• C. MS and MR
• D. AS and AR

Answer: (D)

Rheumatic heart disease tends to involve multiple valves and produce mixed lesions rather than a single isolated abnormality. When the aortic valve is affected, inflammation and scarring can cause both stenosis (impaired outflow) and regurgitation (valve incompetence) at the same time. Seeing both aortic stenosis and aortic regurgitation together is a strong clue that rheumatic pathology is at work on the aortic valve, especially in a setting where other valves (like the mitral) may also be involved. Therefore, the combination of AS and AR best fits a rheumatic etiology in this context.

Rheumatic heart disease tends to involve multiple valves and produce mixed lesions rather than a single isolated abnormality. When the aortic valve is affected, inflammation and scarring can cause both stenosis (impaired outflow) and regurgitation (valve incompetence) at the same time. Seeing both aortic stenosis and aortic regurgitation together is a strong clue that rheumatic pathology is at work on the aortic valve, especially in a setting where other valves (like the mitral) may also be involved. Therefore, the combination of AS and AR best fits a rheumatic etiology in this context.