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Thrombosis of Prosthetic Cardiac Valve: Difficulties of Diagnostics on the Example of a Clinical Case with Lethal Outcome

https://doi.org/10.20996/1819-6446-2020-06-13

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Abstract

The article describes the clinical observation of thrombosis of prosthetic cardiac valve in a 51-year-old female patient, 9 years after surgical intervention for a degenerative aortic valve disease with the installation of mechanical prosthesis into the aortal position and further warfarin medication, with absence of international normalized ratio (INR) control over the past six months. The patient's condition worsened under the “mask” of decompensation of left ventricular circulatory failure; pulmonary embolism and acute coronary syndrome were also excluded. At the same time, the negative dynamics of the cardiac ultrasound data were underestimated: the appearance of prosthetic dysfunction, an increase in the degree of valve regurgitation, severe pulmonary hypertension, as well as anamnestic data (double acute cerebrovascular accident and lack of INR control for a long time, lability of its values during index hospitalization).This case can be important in terms of clarifying the reasons for the decompensation of chronic cardiac failure in patients with valvular defects and mechanical valve prosthetics, especially in cases of irregular INR monitoring or not being it in the target range, and progressive negative dynamics of the cardiac ultrasound data.

About the Authors

A. A. Novoselova
Ryazan State Medical University named after Academician I.P. Pavlov
Russian Federation

Anastasia A. Novoselova - Student, Ryazan State Medical University named after Academician I.P. Pavlov.

Vysokovoltnaya ul. 9, Ryazan, 390026.



S. S. Yakushin
Ryazan State Medical University named after Academician I.P. Pavlov
Russian Federation

Sergey S. Yakushin - MD, PhD, Professor, Head of Chair of Hospital Therapy with the Course of Medico-Social Examination, Ryazan State Medical University named after Academician I.P. Pavlov.

Vysokovoltnayaul. 9, Ryazan, 390026.



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For citation:


Novoselova A.A., Yakushin S.S. Thrombosis of Prosthetic Cardiac Valve: Difficulties of Diagnostics on the Example of a Clinical Case with Lethal Outcome. Rational Pharmacotherapy in Cardiology. 2020;16(3):399-403. (In Russ.) https://doi.org/10.20996/1819-6446-2020-06-13

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)