Fulminant mitral regurgitation due to ruptured chordae tendinae in acute rheumatic fever

Aims: Description of the presentation and management of cases of fulminant mitral regurgitation in acute rheumatic fever (ARF). Methods: Retrospective case series of 4 children, aged 6-10 years, presenting in acute pulmonary oedema because of rupture of elongation of the chordae tendinae of the mitral valve leading to flail leaflets and severe mitral regurgitation. Results: Urgent cardiac surgery with mitral valve repair was performed. Resolution of heart failure was achieved in each case. The difficulties in diagnosis and management of this uncommon and often unrecognised presentation of ARF are discussed. Conclusions: Cardiac surgery can be life saving for fulminant mitral regurgitation due to rupture of chordae tendinae of the mitral valve in ARF