1. LA clot in Severe Mitral stenosis

    Varying sizes and quality of clots are seen in severe rheaumatic mitral valve stenosis, especially in Asian subcontinent. LA clots are also found in patients with non-valvular atrial fibrillation, but to a lesser extent as compared to rheumatic valvular disesase and are seen more in the advanced world. The clots can be fresh ones or multilayered organised clots or a mixture of the two. In severe mitral stenosis, because of the obvious stasis of blood in LA, there are high possibilities of clot formation, and this is seen more so in the Indian subcontinent due to poor patinet compliance with anticoagulation therapy and this is a major issue in the management of patients with rheumatic mitral stenosis.This leads to various complications such as Stroke, TIA, and embolisation to various other systemic organs and lower limbs ausing ischemia. It is important to treat these patients as an urgent case for LA clot removal and Mitral valve repalcement along with surgical management of lower limb ischemia.

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