Figure 10.&amp;nbsp; Acute rheumatic fever with acute aortic incompetence and acute mitral incompetence due to rupture of the chordae tendineae. A: Chest Xray shows cardiomegaly and extensive alveolar infiltrates; B: Chest Xray after intubation. An ECHO study showed aortic valve incompetence and mitral vale incompetence; C: Chest Xray after replacement of the aortic valve and the mitral valve.