Authors : Achal Karande, Pankaj Banode, Anurag Luharia, Gaurav Mishra, Sneha Shrungare, Vedanti Chirde
DOI : 10.4103/jdmimsu.jdmimsu_9_24
Volume : 19
Issue : 3
Year : 2024
Page No : 618-619
A male in his late sixties came to the department of medicine with chief presenting complaints of acute shortness of breath, swollen legs and feet, and fatigue seeking medical attention for 1 month, aggravating on exertion and relieving at rest. It was revealed as a part of history that the patient had undergone aortic valve replacement (AVR) in 2016 and was a known case of diabetes mellitus. On systemic examination, the patient was subjected to echocardiography, and a provisional diagnosis of aortic valve insufficiency was kept as echocardiography confirmed the significant valvular leak, prompting an aortogram shown in Figure 1. The digital subtraction angiogram revealed a paravalvular leak evident in the aorta angiogram as shown in Figure 2 and leaflets of the aortic valve in x-ray shown in Figure 3 and transesophageal echocardiogram, indicating AVR. while contrast extravasation suggested the paravalvular leak shown in Figure 4. The patient was reportedly well a few days prior and had no history of hypertension, tuberculosis, bronchial asthma, fever, cough, or gastrointestinal symptoms. The prescribed medications included oral hypoglycemic and antiplatelet drugs since the patient had a previous cardiac interventional procedure in 2016 and antiepileptic drugs as he had a previous history of right temporal intraparenchymal bleed. Following consultation with cardiovascular and thoracic surgery (CVTS), the patient’s hemodynamic and vital parameters improved during the hospital stay. The discharge plan included the continuation of previous medications.