<prompt> Which of the following is usually not seen in rheumatic heart disease?MSTSASPS  <response>: Ans. d. PS Ref: Harrison 19e p 1547, 18e p1930Pulmonary 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, unicuspidQ Degenerative calcificQ Rheumatic feverQ RadiationQAortic regurgitationValvularRoot disease Congenital bicuspidQ EndocarditisQ Rheumatic feverQ MyxomatousQ prolapse Traumatic SyphilisQ Ankylosing spondylitisQ Aortic dissectionQ Cystic medial degenerationQ Marfans syndromeQ Bicuspid aortic valve Nonsyndromic familial aneurysm AortitisQ HypertensionQTricuspid stenosis RheumaticQ CongenitalTricuspid regurgitationPrimarySecondary RheumaticQ EndocarditisQ MyxomatousQ TVP CarcinoidQ RadiationQ Congenital EbsteinsQ 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 Marfans syndrome 