P. V. R. S. Subrahmanya Sarma1, Adilakshmi B2
PRESENTATION OF CASE
A 30 yrs. old patient presented to cardiology outpatient clinic in GGH Vijayawada with a history chronic rheumatic heart disease with severe mitral insufficiency with moderate LV dysfunction and patient underwent mitral valve replacement with 24 size St Jude bi-leaflet mitral prosthesis five years back, Later she had history of still birth pregnancy 4 yrs. back, after which she lost follow up. She again presented with breathlessness along with history of orthopnea and PND attacks since one month. but not using any kind of medication, her clinical examination showed that she is having basal crepitations with S3 gallop rhythm on auscultation and her ECG was shown to have atrial fibrillation, with fast ventricular rate.