Globally, rheumatic fever is the leading cause of MV stenosis. The onset of clinical symptoms indicating MV obstruction following an initial episode of rheumatic fever can vary significantly, emerging anywhere from a few years to over 20 years later. Common symptoms experienced by patients in the early stages of the disease include exertional dyspnea, orthopnea, pulmonary edema, hemoptysis, palpitations (atrial fibrillation), and systemic embolic events, with cerebral emboli occasionally presenting as the initial symptom. Prolonged severe MS and elevated LA pressure can result in pulmonary hypertension, which in turn may lead to RV failure and severe TR. At this stage, patients often present with fatigue, peripheral edema, and signs of low cardiac output. Currently, percutaneous valvuloplasty utilizing a specialized balloon design (the Inoue balloon) is the preferred treatment approach for suitable patients, offering long-term outcomes comparable to OMVC. While procedure-related complications are generally minimal, rare but potentially devastating events like cerebral thromboembolism can occur. Multiple studies have demonstrated the safety and life-saving benefits of this procedure during pregnancy.