Abstract:
Background. Patients with mechanical aortic valve prostheses generally have a favorable
long-term prognosis. The progressive development of valvular dysfunction and pulmonary
hypertension may adversely affect prognosis and quality of life, underscoring the
importance of regular monitoring for optimal management.
Objective(s). This case report presents the 10-year long-term evolution of a mechanical
aortic prosthesis and the impact of valvular complications on the patient’s overall clinical
status.
Materials and methods. A 79-year-old female patient was admitted to the Cardiac
Rehabilitation Department of SCM “Sfânta Treime.” Clinical and paraclinical data and history
were obtained from the medical record. The patient was evaluated by echocardiography,
electrocardiography, chest radiography, abdominal ultrasound, and routine biochemical
and hematological tests.
Results. The patient presented with dyspnea on minimal exertion, palpitations, fatigue.
Exam revealed pale-pink skin, moderate peripheral edema, reduced basal vesicular murmur,
irregular heart sounds, systolic murmur at the apex, HR 84 bpm, BP 170/80 mmHg.
Paraclinical findings: Hb 116 g/L, RBC 4.57 x10¹²/L, WBC 9.86 x10⁹/L. Echocardiography:
status post mechanical aortic valve replacement, Grmax = 23.0 mmHg, moderate mitral
stenosis, mitral regurgitation grade II–III, LVEF = 56%, moderate pulmonary hypertension.
Chest X-ray: bilateral pneumosclerosis, CTI= 52.83%. Treatment: beta-blockers, ARBs,
antiarrhythmics, anticoagulants, diuretics, statins.
Conclusion(s). The patient’s complex clinical manifestations, correlated with pulmonary
hypertension, mitral stenosis and regurgitation, highlight the necessity of thorough
paraclinical evaluation. Echocardiography plays a central role in imaging monitoring and
optimizing the management of cardiopulmonary disease.
