Which statement describes the pattern of valve involvement in rheumatic disease?

Which statement describes the pattern of valve involvement in rheumatic disease?

• A. Mitral valve is typically affected first
• B. Aortic valve is first
• C. Both valves always affected simultaneously
• D. Neither valve affected

Answer: (A)

In rheumatic heart disease, the initial valve involvement is most commonly the mitral valve. This happens because the mitral valve is subjected to high pressures on the left side of the heart and is more exposed to the inflammatory processes triggered by the immune response after a streptococcal infection. The result is early valvular damage, often manifesting later as mitral stenosis or mitral regurgitation. As the disease progresses, the aortic valve can become involved, but it is less likely to be affected first. Other valves are less commonly involved, and it is not necessary for both valves to be affected or for neither valve to be involved.

In rheumatic heart disease, the initial valve involvement is most commonly the mitral valve. This happens because the mitral valve is subjected to high pressures on the left side of the heart and is more exposed to the inflammatory processes triggered by the immune response after a streptococcal infection. The result is early valvular damage, often manifesting later as mitral stenosis or mitral regurgitation. As the disease progresses, the aortic valve can become involved, but it is less likely to be affected first. Other valves are less commonly involved, and it is not necessary for both valves to be affected or for neither valve to be involved.