Safe Use of Valproate and Olanzapine for Psychotic Mania in Rheumatic Heart Disease

Abstract Rheumatic heart disease (RHD) is a sequela of either single or multiple episodes of rheumatic fever, usually caused by beta-hemolytic streptococci. Neuropsychiatric manifestations include Sydenham’s chorea, depression, anxiety, and obsessive-compulsive symptoms. This case report discusses a case of a 32-year-old female with symptomatic RHD who presented with psychotic mania, a comorbidity rarely reported in the medical literature. We want to envisage the safe and effective use of valproate and olanzapine for the management of behavioral symptoms in the management of psychotic mania in conjunction with RHD.