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Echocardiography of a woman after valve intervention
  1. Anderson Ferreira Leite1,
  2. Paulo Henrique Nogueira Costa1,
  3. Luisa Freire Pederneiras Barbosa1,
  4. Timothy C Tan2,
  5. Claudio Leo Gelape1,
  6. Maria Carmo Pereira Nunes1
  1. 1Hospital das Clinicas, School of Medicine of the Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
  2. 2Cardiac Ultrasound Lab, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr. Anderson Ferreira Leite, Rua Almandina, 68, Santa Teresa, Belo Horizonte, MG 31010-080, Brazil; anderson_med125{at}yahoo.com.br

https://doi.org/10.1136/heartjnl-2014-305507

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    A 48-year-old woman presented with progressively worsening exertional dyspnoea. Physical examination revealed an accentuated first heart sound, opening snap and holodiastolic mitral murmur. A transthoracic echocardiogram showed severe rheumatic mitral stenosis (valve area: 0.7 cm2; mean pressure gradient: 23 mm Hg; pulmonary artery systolic pressure: 60 mm Hg), mild-to-moderate mitral regurgitation (MR), with a Wilkins score of 7 and valvular anatomy favourable for percutaneous mitral valvuloplasty (PMV). After three successive balloon dilations, the valve area increased to 1.2 cm2, transmitral gradient decreased to 5 mm Hg and mean pulmonary artery pressure to 33 mm Hg. The patient remained stable after the procedure, asymptomatic during hospitalisation, and routine 2D and 3D echocardiography images were obtained before discharge from hospital (figure 1 and online supplementary videos 1 and 2).

    Figure 1

    Two-dimensional (2D) TTE and 2D TEE echocardiographic image of …

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    Footnotes

    • Contributors All authors have read and approved the case. Each author has contributed significantly to the work. AFL was responsible for conception, design, review of literature and writing the case; PHNC and CLG were responsible for the cardiac surgery, LFPB and TCT helped in the design of the case and MCPN made important contributions to interpretation of the images.

    • Competing interests None.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; internally peer reviewed.