Abstract
A 75-year-old female with a past medical history of type 2 diabetes mellitus, hypertension, and implantable cardioverter-defibrillator (ICD) and chronic left ventricular systolic dysfunction for over 5 years presented with increasing exertional dyspnea. Three months ago, she suffered syncope with ICD interrogation with ventricular fibrillation, and successful delivery of shock therapy. At that time, she underwent coronary angiography that demonstrated no obstructive coronary artery disease. An echocardiogram demonstrated LV ejection fraction 15% and a dilated left ventricle (end-diastolic dimension by M-mode echocardiography 81 mm) with decreased right ventricular function and severe mitral regurgitation (MR). There is no evidence of mitral valve prolapse, prior endocarditis, or other valve leaflet pathology. Of note, the MR has been present for the past 2 years, with a slow, progressive dilatation of the LV, though she has remained relatively asymptomatic (class I–II) with most daily activities. She is on carvedilol 12.5 mg twice a day, lisinopril 5 mg daily, and furosemide 20 mg twice a day.
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Shah, R.V., William Dec, G. (2018). Valvular Disease and Heart Failure: Mitral Regurgitation. In: Shah, R., Abbasi, S. (eds) Clinical Cases in Heart Failure. Clinical Cases in Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-319-65804-9_4
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