Embolic stroke in young adults: Investigating the role of rheumatic mitral stenosis in cerebrovascular events

We report a case of early-onset ischemic stroke in a previously healthy 39-year-old female, attributed to rheumatic mitral stenosis (MS) and atrial fibrillation (AF). The patient presented with acute-onset hemiparesis, dysarthria, and facial asymmetry, with symptoms developing within six hours prior to hospital admission. Comprehensive cardiac assessment revealed severe mitral valve stenosis, a rapid ventricular response secondary to atrial fibrillation, and marked left atrial enlargement. Management involved anticoagulation therapy, statin administration, and rhythm control. The patient demonstrated a favorable recovery, achieving a modified Rankin Scale (mRS) score of 2 at discharge after a 10-day hospitalization. This case underscores the importance of identifying rheumatic mitral stenosis as a significant etiological factor for ischemic stroke in young adults.