Acute Rheumatic Fever With Carditis In Pregnancy: A Case Report

Rheumatic fever  (RF)  is the consequence of a previous group A haemolytic streptococcal infection, which may be cured or evolve in a serious deformation of the cardiac valves. It is most common among children aged 5-15 years and very rare after age 35 years  [1] . In developing countries, rheumatic heart disease (RHD) remains a significant cause of cardiovascular morbidity and mortality [2] . It affects More than 15.6 million people globally  and 233,000 die of the disease each year around the world. [3] . Current data about the incidence of RHD during pregnancy in KSA  is lacking , but The general incidence  and consequent endocarditis is reported as low (0.006%) [4,5]  . even though the low incidence of the disease during pregnancy is of challenging diagnosis and management. Pregnancy causes a significant hemodynamic changes : 25% increase in cardiac output, 40% increase in plasma volume, increased oxygen requirements, retention of salt and water, weight gain, and alterations in hemodynamic during delivery. Which all can be tolerated by normal heart , but these changes have a different impact for women with RHD [6].