From Strep Infection to a Strepitous Heart Pattern in Rheumatic Fever: A Case Report.

Rheumatic heart disease (RHD) is the leading cause of valvular heart disease globally, arising from acute rheumatic fever (ARF). It results from an abnormal immune response to group A streptococcal (GAS) infection, leading to myocardial injury. This is the case of a 65-year-old female with severe mitral regurgitation (MR) secondary to RHD disease who develops acute heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF), both de novo. It underscores the role of echocardiography in early diagnosis and severity assessment of RHD, antibiotic prophylaxis strategies, and the management of complications.