Abstract
Although involvement of all four heart valves has been known to occur in patients with acute rheumatic carditis, quadrivalvular involvement is extremely rare in patients with chronic rheumatic heart disease [1]. Less than 20 cases have been reported in the English medical literature [2–7]; only five of these patients have been successfully operated upon [2–4]. In an earlier communication, we had reported the autopsy findings in a 20-year-old woman with rheumatic quadrivalvular heart disease [5].
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