A
38-year-old female presented for evaluation of dyspnea on exertion. She also
complained of palpitations but gave no history of edema, chest pain,
cardioembolism, fever, arthralgia or weight loss. She was in atrial
fibrillation (AF) with a controlled ventricular rate.
Cardiac auscultation
revealed a loud S1 with an opening snap and a mid-diastolic rumbling murmur at
the apex. There was no presystolic accentuation and no postural variations.
Transthoracic echocardiogram revealed thickening and restricted motion of
mitral valve leaflets associated with doming of anterior mitral leaflet and
severe subvalvular deformity. Mitral valve area was 0.8 cm2. These findings
were consistent with severe rheumatic mitral stenosis (MS). Read More>>>>>>>
