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The Cardiology Tutor
48 members • Free
1 contribution to The Cardiology Tutor
Sep 20 •
❓ Saturday Challenge – Advanced Cardiology Question
Here’s a tough one for you 🫀: A 68-year-old woman presents with progressive exertional dyspnoea and fatigue. On examination: - BP: 110/70 mmHg - Pulse: irregularly irregular, 96 bpm - JVP: raised - Apex beat: tapping, not displaced - Auscultation: loud S1, opening snap, mid-diastolic rumbling murmur at the apex, best heard in left lateral position. 💡 Question: 1. What is the most likely diagnosis? 2. What is the single most important complication she is at risk of developing? Drop your answers below 👇 — I’ll reveal the correct answers and explanation this evening.
0 likes • Sep 20
Atrial fibrillation caused by mitral stenosis. High risk of an ischaemic stroke. The patient needs to be started on anticoagulant therapy, for example Apixaban
0 likes • Sep 20
@Nabila Laskar Thank you! Warfarin would be first-line here. It is believed to be more effective since it inhibits factor VII, factor IX, factor X, and thrombin. Whereas DOAC’s block individual factors. Since patients with rheumatic mitral valve stenosis and atrial fibrillation are at a very high risk of stroke, a strong anticoagulant whose therapeutic range we can closely monitor, such as warfarin, would be recommended here
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