Differential Diagnosis
- Single most likely diagnosis
- D. Rheumatic fever: This is the most likely diagnosis due to the presence of mitral valve abnormalities, such as partial fusion of the leaflets, thickening and shortening of the chordae tendineae, and an enlarged left atrium. These findings are characteristic of rheumatic heart disease, which is a common complication of rheumatic fever.
- Other Likely diagnoses
- B. Systemic lupus erythematosus: This condition can cause Libman-Sacks endocarditis, which may lead to mitral valve abnormalities and atrial fibrillation. However, the presence of mural thrombus and the specific valve changes described are more suggestive of rheumatic fever.
- C. Infective endocarditis: This condition can cause valve damage and atrial fibrillation, but the described valve changes and the presence of an enlarged left atrium with mural thrombus are more characteristic of rheumatic heart disease.
- Do Not Miss
- E. Coronary atherosclerosis: Although less likely to be directly related to the valve changes, coronary atherosclerosis can cause atrial fibrillation and increase the risk of stroke. It is essential to consider this diagnosis, as it may have contributed to the patient's death.
- Rare diagnoses
- A. Tuberculosis: Tuberculosis is not typically associated with the described valve changes or atrial fibrillation. While it can cause pericarditis and other cardiac complications, it is an unlikely cause of this patient's condition.
- Other rare conditions, such as carcinoid heart disease or cardiac sarcoidosis, may also cause valve abnormalities and atrial fibrillation, but they are less likely than rheumatic fever in this case.