Echocardiography in the long-term follow-up of a mechanical aortic prosthesis – a clinical case with associated valvular disease

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.