Ultrasound Registry Review (URR) MV Abnormalities and Disease Practice Test

Rheumatic heart disease most often targets the left-sided valves, with the mitral valve being affected far more than the others. The immune-driven inflammation after a streptococcal infection causes thickening and fusion of the mitral leaflets at the commissures, along with shortening of the chordae tendineae. This remodeling commonly leads to mitral stenosis and can accompany mitral regurgitation. The mitral valve bears the brunt because of the high pressure it encounters in the left heart, making it the most susceptible valve. The aortic valve is involved less frequently, and the tricuspid and pulmonary valves are affected even less due to lower pressures on the right side of the heart. In chronic rheumatic disease, mitral stenosis is the classic lesion that often dominates, reflecting why the mitral valve is the most commonly affected.