Sinha Santosh Kumar, Thakur Ramesh, Krishna Vinay, Varma Chandra Mohan, Goel Amit, Jha Mukesh Jitendra, Kumar Ashutosh, Mishra Vikas, Tiwari Pradyot, Sinha Rupesh
Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India.
LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India.
Cardiol Res. 2015 Dec;6(6):357-361. doi: 10.14740/cr437w. Epub 2015 Dec 16.
Rheumatic disease may involve the pulmonary valve, but is exceedingly rare. Simultaneous involvement of all four valves is more likely to be the result of combination of causes, such as congenital, rheumatic, infective or degenerative disease. A unitary cause for quadrivalvular involvement would be either rheumatic or myxomatous degeneration. A 16-year-old young boy presented with progressive exertional dyspnea for the past 3 years. On evaluation, he was in atrial fibrillation with congestive heart failure. On examination, evidence of stenosis of the mitral, aortic and tricuspid valves with a history of rheumatic fever in childhood was revealed. Transthoracic echocardiography showed the quadrivalvular involvement. Only few reports are available in the literature describing rheumatic quadrivalvar damage and that too in third and fourth decade. This is probably first to be reported in juvenile age group.
风湿性疾病可能累及肺动脉瓣，但极为罕见。同时累及所有四个瓣膜更可能是多种病因共同作用的结果，如先天性、风湿性、感染性或退行性疾病。导致四瓣膜受累的单一病因可能是风湿性或黏液瘤样变性。一名16岁的年轻男孩在过去3年中出现进行性劳力性呼吸困难。经评估，他处于房颤伴充血性心力衰竭状态。检查发现有二尖瓣、主动脉瓣和三尖瓣狭窄的证据，且有儿童时期风湿热病史。经胸超声心动图显示四瓣膜均受累。文献中仅有少数报道描述风湿性四瓣膜损害，且多为三四十岁患者。这可能是首次在青少年年龄组中报道。
