A Rare Case of Multivalvular Prolapse

Acute rheumatic fever (ARF) is the leading cause of acquired heart disease in children and young adults worldwide. The mean incidence of ARF globally is 5-50/100000 [1]. Initiated by a pharyngeal infection with group A beta hemolytic streptococci (GAS), after a latent period of two to three weeks, the illness is characterized by acute inflammation of the heart, joints, subcutaneous tissue and central nervous system. The theory of molecular mimicry holds that the GAS pharyngitis triggers an autoimmune response to epitopes in the organism that cross react with similar epitopes in the heart, brain and joints [2]. In rheumatic carditis, mitral and aortic valves are commonly involved followed by tricuspid and pulmonary valves. We report a case of all four valves involvement with prolapse as the predominant cause of pathologic regurgitation along with review of literature.