Acute Lower Extremity Embolism Resulting in Rheumatic Mitral Stenosis: A Case Report

Abstract

A 52-year-old woman was admitted with sudden onset of acute arterial occlusion in the right lower limb. We found 3-4/6 diastolic murmur and, in the ECG, rapid ventricular response in atrial fibrillation. The patient underwent an emergency operation. We applied transthoracic and transesophageal echocardiography to investigate the etiology of thromboembolism and diagnosed the patient with mitral stenosis. The patient was recommended for a mitral valve surgery. Preoperative coronary angiography revealed a normal picture. The mitral valve was resected in the operation. We also performed carbon-coated bileaflet prosthetic valve replacement. The left atrial appendix was ligated. The patient did not have any postoperative clinical problems. Having recommended appropriate medical treatment, the patient was discharged. In conclusion, thromboembolism and atrial fibrillation in patients with rheumatic heart diseases should be kept in mind throughout the diagnosis process.

Keywords: Thromboembolism; Mitral Stenosis; Atrial Fibrillation.

Keywords

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Journal of Turgut Ozal Medical Center

Öz

Elliiki yaşında bayan hasta sağ alt extremitede ani başlayan akut arteriel tıkanıklık bulgusu ile yatırıldı. Mitral dinleme odağında 3-4/6 diastolik üfürüm ve elektrokardiografisinde hızlı ventrikül yanıtlı atrial fibrilasyon tesbit edildi. Acil ameliyata alındı. Tromboemboli etiyolojisini araştırmak amacıyla yapılan transtorasik ve transözefageal ekokardiografisinde mitral stenoz tesbit edildi. Hastaya mitral kapak cerrahisi önerildi. Ameliyat öncesi yapılan koroner anjiografisinde koronerler normal olarak saptandı. Operasyonda mitral kapak çıkartılarak karbon kaplı bileaflet protez kapak ile replasman yapıldı. Sol atrial apendix bağlandı. Operasyon sonrası klinik problem yaşanmadı. Uygun medikal tedavi düzenlenerek hasta taburcu edildi. Sonuç olarak kliniği tromboemboli ile ortaya çıkan ve atrial fibrilasyonu olan hastalarda romatizmal kalp hastalığı akılda tutulmalıdır

Anahtar Kelimeler

• Tromboemboli, Mitral Stenoz, Atrial Fibrilasyon

Kaynakça

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