Which of the following is usually not seen in rheumatic heart disease?

Ans. d. PS (Ref: Harrison 19/e p 1547, 18/e p1930)Pulmonary stenosis (PS) is usually not seen in rheumatic heart disease.Major Causes of Valvular Heart DiseasesValve LesionEtiologiesMitral stenosis* Rheumatic feverQ* CongenitalQ* Severe mitral annular calcification* SLE, RAMitral regurgitationAcuteChronic* EndocarditisQ* Papillary muscle ruptureQ (post-MI)* Trauma* Chordal rupture/ leaflet flail MVP, IE)* MyxomatousQ (MVP)* Rheumatic feverQ* EndocarditisQ (healed)* Mitral annular calcification* Congenital (cleft, AV canal)* HOCM with SAM* Ischemic (LV remodeling)* Dilated cardiomyopathy* RadiationAortic stenosis* Congenital (bicuspid, unicuspid)Q* Degenerative calcificQ* Rheumatic feverQ* RadiationQAortic regurgitationValvularRoot disease* Congenital (bicuspid)Q* EndocarditisQ* Rheumatic feverQ* MyxomatousQ (prolapse)* Traumatic* SyphilisQ* Ankylosing spondylitisQ* Aortic dissectionQ* Cystic medial degenerationQ* Marfan's syndromeQ* Bicuspid aortic valve* Nonsyndromic familial aneurysm* AortitisQ* HypertensionQTricuspid stenosis* RheumaticQ* CongenitalTricuspid regurgitationPrimarySecondary* RheumaticQ* EndocarditisQ* MyxomatousQ (TVP)* CarcinoidQ* RadiationQ* Congenital (Ebstein'sQ)* Trauma* Papillary muscle injuryQ (post-MI)* RV and tricuspid annular dilatation* Multiple causes of RV enlargement (e.g., long- standing pulmonary HTN)* Chronic RV apical pacingPulmonic stenosis* Congenital* CarcinoidQPulmonic regurgitationValve diseaseAnnular enlargement* Congenital* Postvalvotomy Endocarditis* Pulmonary hypertension* Idiopathic dilation* Marfan's syndrome