Renal and Splenic Infarctions in Rheumatic Mitral Valve Disease

A young adult presented with acute renal and splenic infarctions, leading to the discovery of underlying rheumatic mitral valve disease, according to a case report published in Cureus.

The patient experienced sudden onset of flank pain and abdominal discomfort, prompting imaging studies that revealed multiple infarcts in both kidneys and the spleen. Computed tomography angiography confirmed the infarctive lesions, which were initially unexplained given the patient’s age and lack of traditional cardiovascular risk factors.

Further cardiac evaluation identified significant mitral stenosis due to rheumatic heart disease, a condition resulting from untreated or inadequately treated group A streptococcal infection that causes scarring and narrowing of the mitral valve. This valvular abnormality led to atrial fibrillation and subsequent thromboembolism, explaining the renal and splenic infarctions.

The case highlights how rheumatic mitral valve disease, though less common in developed countries, can still present unexpectedly in young adults with embolic phenomena as the initial manifestation. Clinicians are advised to consider valvular heart disease in young patients with unexplained infarctions, particularly when standard risk factor assessment is negative.

Treatment involved anticoagulation to prevent further thromboembolic events and management of heart failure symptoms. Long-term follow-up is recommended to monitor valve function and assess the need for potential intervention such as balloon valvuloplasty or valve replacement.

This case underscores the importance of a thorough cardiac workup in young patients presenting with ischemic organ damage, as treatable structural heart disease may be the underlying cause rather than atherosclerosis or hypercoagulable states typically suspected in older populations.