Case and Plan:
PF, 83 Y/O F
Presentation: Presents with progressive dyspnea on exertion, NYHA class III
PMH: Moderate to severe MR (diagnosed 2y prior, echo every 3 months), persistent Afib (s/p DCCV), SSS, severe pulmonary HTN, type 2 diabetes, HTN, HLD, anxiety, depression.
Medications: Clopidogrel, Amiodarone, Empagliflozin, Furosemide, ISMN, Metformin+Sitaglaptin, Levothyroxine, Atorvastatin, Nifedipine
Labs: Hgb 10.4, PLT 222K, Cr 1.25, INR 1.2
EKG: Atrial fibrillation
TTE : Severe MR, flail posterior mitral leaflet, LVEF 66%, moderate MAC, mild-moderate TR, PASP 66 mmHg
