Juvenile rheumatic mitral stenosis in association with perimembranous ventricular septal defect in a 3-year-old boy.

Rheumatic mitral stenosis (MS) is a well-known entity in the developing world. Though rarely seem, MS can present at a very young age with severe symptoms. We describe here an unusual association of a large perimembranous ventricular septal defect with juvenile rheumatic MS leading to severe pulmonary hypertension and heart failure in a very young child.