Giant Left Atrium Due to Severe Rheumatic Double Mitral Valve Dysfunction

Abstract

A 59-year-old woman, active smoker, with permanent atrial fibrillation under oral anticoagulation and long-term diagnosed double mitral valve dysfunction secondary to rheumatic heart disease (RHD), was admitted to the emergency department due to refractory dyspnea at minimal exertion. Transthoracic echocardiography at rest revealed rheumatic severe double mitral dysfunction: mitral valve area 0.79 cm2; maximum and medium transmitral gradient