scholarly journals DOAC FAILURE TO PREVENT ISCHEMIC STROKE IN ATRIAL FIBRILLATION PATIENT WITH MITRAL VALVE STENOSIS

2021 ◽  
Vol 77 (18) ◽  
pp. 2986
Author(s):  
Eiman Elhouderi ◽  
Mustapha Choucair ◽  
Zainab Almusawi ◽  
Saba Abdulsada
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Mitral Valve ◽  
Atrial Fibrillation Patient ◽  
Mitral Valve Stenosis

scholarly journals P1705 Is mitral stenosis per se worthy of anticoagulation therapy?

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Suma ◽  
N Gaibazzi
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Left Atrium ◽  
Thrombus Formation ◽  
Anticoagulation Therapy ◽  
Mitral Valve Regurgitation ◽  
Low Flow ◽  
Mitral Valve Stenosis ◽  
Color Flow ◽  
Tight Correlation

Abstract We present the case of a 76-year-old man with hypertension and previous mitral valve repair (MVR) due to severe mitral valve regurgitation. He had never experienced atrial fibrillation (AF), and therefore he was not anticoagulated. He had been asymptomatic for 15 years, however, recently he reported the onset of dyspnoea and a transthoracic echocardiogram showed moderate to severe mitral valve stenosis (MVS) in the context of previous MVR. A transesophageal echocardiogram was then requested and it confirmed the degree of MVS (panel A Color flow on mitral valve, panel B CW Doppler), but, astonishingly, it also showed the presence of a giant thrombus in the roof of the left atrium (Panel C,D,F 2D TOE, Panel E 3D TOE). The maximal dimensions of the mass were 3.3 to 4.5 centimetres and, surprisingly, no thrombus was found in the left appendage, which nevertheless had low-flow. MVS is very often associated with severe left atrial dilation and with the onset of atrial fibrillation. However, when a patient has at least moderate MVS and he is in sinus rhythm, there is no robust evidence supporting the initiation of anticoagulants. Though, this case underlines the tight correlation between MVS and thrombus formation regardless of the detectable presence of AF. Moreover, in contrast to usual AF patients, in this particular case left appendage was not involved and the huge mass occupied most of the left atrium, showing that MVS provokes significant low-flow in the atrium too. Abstract P1705 Figure.

Clinical, Echocardiographic, and Hemodynamic Characteristics of Rheumatic Mitral Valve Stenosis and Atrial Fibrillation

Angiology ◽  
2005 ◽  
Vol 56 (2) ◽  
pp. 159-163 ◽  
Author(s):  
Mehmet Kabukçu ◽  
Esin Arslantas ◽  
Ismail Ates ◽  
Fatih Demircioglu ◽  
Filiz Ersel
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Mitral Valve Stenosis ◽  
Hemodynamic Characteristics

scholarly journals An Unusual Association of Aortic Valve Fibroelastoma and Mitral Valve Stenosis

2018 ◽  
Vol 11 (21) ◽  
pp. 51-53
Author(s):  
Francisco Javier Cabral Amador ◽  
Ricardo Elio Florian Ruiz
Keyword(s):  
Ischemic Stroke ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Previous History ◽  
Mitral Valve Stenosis ◽  
Unusual Association ◽  
History Of

The etiology of mitral valve stenosis is due to degenerative calcific disease. We report a case of a woman with an aortic supravalvular mass associated to a mitral valve stenosis with previous history of ischemic stroke.

scholarly journals P1312 Implications of a large atrial roof thrombus

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
P Fountoulakis ◽  
E Hamodraka ◽  
A Siama ◽  
A Tsoukas ◽  
A J Manolis
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Transesophageal Echocardiography ◽  
Left Atrium ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Posterior Wall ◽  
Mitral Valve Stenosis ◽  
Systemic Embolism ◽  
Intracardiac Thrombi

Abstract Funding Acknowledgements No funding Introduction Rheumatic heart disease is the most common cause of mitral valve stenosis. Rheumatic valve disease presents a strong predisposing factor to intracardiac thrombi formation in the left atrium, particularly when there is a background of atrial fibrillation. The predominant location for thrombus creation is the left atrial appendage, due to its morphology, and rarely the free wall or roof of the left atrium. In either case, the presence of intracardiac thrombi in the left cardiac cavities poses a severe risk factor for systemic embolism which can prove detrimental for the patient leading to increased morbidity and mortality. Transesophageal echocardiography remains the gold standard for screening of the left atrium. Case presentation We present the case of a 72 year old woman who was admitted to the Emergency Department of our Hospital because of palpitations and progressive weakness over the last month. She had a known history of rheumatic mitral valve stenosis and chronic atrial fibrillation under standard anticoagulant treatment with acenocoumarol. Methods - Results: On admission, the patient was hemodynamically stable without signs of heart failure. The electrocardiogram revealed atrial fibrillation with a ventricular rate of approximately 135 bpm. Chest X-Ray did not demonstrate any signs of pulmonary congestion. Blood tests were normal, except from a subtherapeutic INR 1.3. Transthoracic echocardiography depicted a suspicious large echogenous mass located on the posterior wall of the left atrium. Furthermore, there was severe mitral valve stenosis with calcification of the mitral annulus as well as reduced mobility of the leaflets (Mitral Valve Area ∼0.8 cm2, Mean gradient = 15 mmHg) and mild aortic valve stenosis. The left ventricle had normal dimensions and good overall systolic function. Systolic pulmonary pressure was estimated at 50 mmHg. Transesophageal echocardiography confirmed the presence of a large echogenous mass (2,6 x 2,9 cm) located on the posterior wall of the left atrium between the right and left pulmonary veins as well as another mass at the left atrial appendage. Contrast echocardiography ensued, which revealed no absorption of the contrast medium by the mass thus suggesting a lesion with no vascularity, compatible with thrombus. Furthermore there was diffuse slow flow within the left atrium (smoke) indicating blood stasis. The patient was treated with a cardioselective beta blocker and combination of aspirin and acenocoumarol with a target INR of 2,5-3 and was referred for cardiothoracic consultation. Conclusion/Discussion: We describe a rare case of moderate mitral stenosis with presence of a large thrombus with mobile parts in an unusual location. In this setting the indication for surgery (mitral valve replacement) is upgraded since there is increased risk of thrombus detachment and debilitating systemic embolism. Abstract P1312 Figure.

scholarly journals Correlation of Atrial Fibrillation with Left Atrial Volume in Patients with Mitral Stenosis. A single centre study from Pakistan

2020 ◽  
Vol 1 (1) ◽  
pp. 23-28
Author(s):  
Muhammad Arshad ◽  
Furqan Yaqub Pannu ◽  
Bilal Ahmad ◽  
Salman Khalid ◽  
Ahmad Kamran ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Mitral Stenosis ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Mitral Valve Stenosis ◽  
Atrial Volume ◽  
Group A ◽  
Group B ◽  
Rheumatic Heart

Background: Rheumatic heart disease has a strong association with mitral valve stenosis. Atrial fibrillation is one of the most common complications of this condition and is a poor prognostic factor. Early detection and prompt management of atrial fibrillation can help to improve the quality of life and increase the life expectancy of the patients. We carried out this study to investigate the significance of left atrial volumetric changes in mitral stenosis and its correlation with atrial fibrillation. Methodology: We audited the data of 60 patients of rheumatic heart disease who had mitral valve stenosis. The patients were randomized into atrial fibrillation (Group A) and normal sinus rhythm (Group B). We conducted this cross-sectional analytical study at Cardiology Department, Mayo Hospital, Lahore, from 1st February 2017 to 31st January 2018. We only included those patients who consented to be a part of this study and fulfilled our predefined inclusion criteria. Left atrial volume was measured by prolate ellipse method and biplane methods on echocardiography. The Data was analyzed on SPSS v20. Results: Sixty patients were included in the study. Among the subjects, thirty-six (60%) were males, and twenty-four (40%) were females. Atrial fibrillation was noted in 43.33% of the patients of mitral valve stenosis. There was a marked difference in the mean volume of the left atrium among the two groups. We observed that the mean area of the mitral valve for Group A patients was larger than that of patients in Group B. Our study showed an inverse correlation between left atrial volume and mitral valve area among Group A patients. Conclusion: Patients of mitral stenosis are at an increased risk of developing atrial fibrillation if the left atrial volume is increasing. All patients with mitral stenosis should have routine echocardiography & measurement of left atrial volumes, so that proper treatment can be started if the left atrial volume is increasing, to prevent atrial fibrillation.

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