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BMJ Case Reports 2012; doi:10.1136/bcr.03.2012.5978
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New onset dyspnoea at 82 years

  1. Panneerselvam Subbiahnadar4
  1. 1Cardiology Department, Eugene Clinic, S K Selvam Hospital, Mettupalayam, India
  2. 2Cardiology Department, PSG Institute of Medical Sciences & Research, Coimbatore, Tamil Nadu, India
  3. 3Obstetrics & Gynaecology Department, S K Selvam Hospital, Mettupalayam, India
  4. 4Family medicine Department, S K Selvam Hospital, Mettupalayam, Tamil Nadu, India
  1. Correspondence to Dr Arunkumar Panneerselvam, drparun1976{at}gmail.com

Description

A 82-year-old woman with sedentary lifestyle presented with New York Heart Association Class IV dyspnoea and orthopnoea of 1 day duration. Clinical examination was unremarkable except for bilateral basal crepitations. There was no murmur on auscultation. Her baseline investigations including blood sugar, urea, creatinine and calcium were normal. Chest x-ray showed pulmonary venous hypertension. Echocardiogram revealed extensive calcification of mitral annulus which caused severe left ventricular (LV) inflow obstruction with gradient of 37/17 mm Hg (figure 1A,B; video 1). In …

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