Case of 40-year-old female: K/c/o rheumatic heart disease with moderate mortal stenosis and mortal regurgitation with severe tricuspid stenosis. Mild pulmonary hypertension. Recent several episodes of atrial flutter ( 2_3 episodes in a year, starting from last year). Dilated LA and RA. Hypertrophic cardiomyopathy with systolic anterior motion present. LVEF at rest 60%.
Cardiac MRI - asymmetric hypertrophic cardiomyopathy is seen, showing a basal anteroseptal predominant hypertrophic phenotype, extending into the basal and mid anterior wall and the Mid anteroseptal segment. No h/o HTN, dm, CAD, CKD, or any other systemic pathology. Currently in sinus rhythm, on metoprolol, furosemide, acitrom, and penicillin IM. Please advise the next step of management for this case. Can we continue on medical management or should go for MVR? If MFR, then what is the best valve prosthetic for mitral…
