An 11-year-old boy presented in distress with tachypnea, holosystolic murmur, and a gallop. Echocardiography revealed mitral valve thickening and severe regurgitation. He required valve replacement with pathology consistent with acute on chronic valvulitis. This case underscores the importance of considering rheumatic heart disease, despite no preceding suspicious history.
Keywords: United States; child, mechanical valve; rare; social determinants of health; socioeconomic.
© 2024 Published by Elsevier on behalf of the American College of Cardiology Foundation.