Question

A 34 year old female presenting to the OPD with migratory arthritis and examination revealed a pan systolic murmur. ECHO was performed which is suggestive of mitral regurgitation. Biopsy image is provided. Diagnosis will be?

• A. Infective endocarditis
• B. Rheumatic heart disease
• C. SABE
• D. Cardiac failure

Answer 1

The Correct Option is B

To determine the correct diagnosis, we need to analyze the key symptoms and findings:

1. The patient is a 34-year-old female presenting with migratory arthritis.
2. An examination reveals a pan systolic murmur.
3. An echocardiogram (ECHO) confirms the presence of mitral regurgitation.
4. A biopsy image was provided (though not visible here).

Each of these points points towards a specific set of diagnoses:

• Migratory arthritis: This is often associated with rheumatic fever, which can lead to rheumatic heart disease.
• Pan systolic murmur: This is commonly heard with mitral regurgitation and is characteristic of conditions affecting the mitral valve.
• Mitral regurgitation: In the context of someone with a previous history of sore throat infections or in a younger patient, this often suggests rheumatic heart disease as opposed to degenerative mitral valve disease which is more common in older individuals.

Given these findings, rheumatic heart disease matches all the symptoms:

• It often follows an untreated or unresolved infection with group A Streptococcus pharyngitis, leading to rheumatic fever, which is known to precede such articular and cardiac findings.

Hence, with the data provided and the clinically relevant information, the diagnosis is Rheumatic Heart Disease.