80 yr presented for dental clearance and was incidentally found to have elevated Tnl. During TTE developed bradycardia, dyspnea, hypotension and abdominal pain
PMH: Severe bicuspid AS s/p Bioprosthetic AVR with 21mm Magna valve in 2007, HTN, HLD, GERD, paroxysmal atrial Flutter, CAD s/p PCI to LAD/D1 (09/03/2021) TTE (9/18/24): Severe bioprosthetic AS (PG/MG/PV/AVA: 64/41/4.0/0.92) with no
AI/PVL, minimal MR, minimal TR and EF 47%
CTA: 9/22/24 with HALT & restricted motion of the posterior bioprosthetic leaflet
Medications: Aspirin, Clopidogrel, Rosuvastatin, Evolocumab, Micardis,
Metoprolol XL, Furosemide
Labs: Hgb 13.5, PLT 157K, Cr 0.93, INR 1.1
EKG: Sinus rhythm with PACs, RBBB
Cath (9/18/2024): Non-Obstructive CAD