心室中膈缺損為第二常見之先天性心臟病，而風濕性二尖瓣狹窄為日益減少之後天性心臟病，常起因於風濕熱感染，同時並存先天性心室中膈缺損及後天性嚴重二尖瓣狹窄為一極為罕見且以往未曾報導之病例，我們報告一中年女性因氣促及下肢水腫而就醫，經心臟超音波及心導管檢查證實同時並存上述兩種疾病，後經手術根治，本報告除報導此一罕見之病例外，同時亦敘述其病史及如何處理此一複雜之心臟病之可能策略。

A ventricular septal defect (VSD) is the second most common congenital heart disease (CHD) in adults. Rheumatic mitral stenosis (MS) is an acquired valvular disease, which develops decades after rheumatic fever, but has had a decreasing frequency in recent years. The coexistence of these 2 types of congenital and acquired heart disease in adults is an extremely rare combination not previously reported. In the present case report, we present a middle-aged woman with heart murmurs, progressive exertional dyspnea, and lower-leg edema. Echocardiography and cardiac catheterization revealed a coexistent supracristal VSD and severe rheumatic MS. The patient simultaneously underwent VSD repair and mitral valve replacement, and her condition remained uneventful in the following days. In the present case report, we report the history and clinical manifestations of this patient and discuss possible strategies to manage this complicated heart problem.