The outcomes of mitral stenosis

Abstract

Background. Valvular heart disease (VHD) affects the population of different age, regardless of their etiology has a lot of complications and death. Rheumatic ethiology was reported in 40 % of valvulopathy and is frequently associated with atrial fibrilation (4.5%), trombembolic complication (5.9%) and infectious endocarditis (5.8%). Early risk assessment is required to increases the chances to avoid unwanted effects of diseases. Case report. A 49-year-old female with complains of dyspnoea at minimal effort, palpitations, low tolerance at fizical activity. From the history of the disease is known that in childhood she suffered rheumatic fever. In 1999 was found mitral stenosis and performed mitral commissurotomy, in 2005 - mitral valve replacement and tricuspid valve annuloplasty. In 2006 -paroxysmal atrial fibrillation. In 2005, 2008, 2011- ischemic stroke. In 2008 - infectious endocarditis of mitral valve prosthesis. The patient is given permanent treatment with: „Acenocoumarol”, ”Spironolactona”, ”Torasemid”, ”Amiodarone”. On examination: heart rate 64 b/min, BP -120/60mmHg. Laboratory: dyslipidemia, on ecocardiography: moderate enlargement of left ventricular diameter and left atrium, mitral regurgitation II degree, aortic – II degree, tricuspid – II degree, pulmonar- II degree. Conclusions. This 49-year-old patient suffered by valvular heart diseases, complicated with infectious endocarditis, paroxysmal atrial fibrillation and three episodes of ischemic stroke which worsened the quality of patient`s life. The prevention and management of these complications requires an understanding of their origin with the aim of to balance the risks wich related with valvular disease and benefits associated with treatment.