title: Fulminant mitral regurgitation due to ruptured chordae tendinae in acute rheumatic fever.
abstract: OBJECTIVE
  Description of the presentation and management of cases of fulminant mitral regurgitation in acute rheumatic fever (ARF).
  
  
  METHODS
  Retrospective case series of 4 children, aged 6-10 years, presenting in acute pulmonary oedema because of rupture of elongation of the chordae tendinae of the mitral valve leading to flail leaflets and severe mitral regurgitation.
  
  
  RESULTS
  Urgent cardiac surgery with mitral valve repair was performed. Resolution of heart failure was achieved in each case. The difficulties in diagnosis and management of this uncommon and often unrecognised presentation of ARF are discussed.
  
  
  CONCLUSIONS
  Cardiac surgery can be life saving for fulminant mitral regurgitation due to rupture of chordae tendinae of the mitral valve in ARF.
authors.affiliation: Kidz First Children's Hospital, Middlemore Hospital, South Auckland, New Zealand.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Anderson
authors.forename: Nigel
authors.initials: N
authors.lastname: Wilson
authors.forename: Ross
authors.initials: R
authors.lastname: Nicholson
authors.forename: Kirsten
authors.initials: K
authors.lastname: Finucane
mesh_terms: D002648:Child; D002815:Chordae Tendineae / Q000293:injuries*; D006335:Heart Injuries / Q000150:complications*; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011654:Pulmonary Edema / Q000000981:diagnostic imaging; D011859:Radiography; D012189:Retrospective Studies; D012213:Rheumatic Fever / Q000150:complications*