Ball-valve Left Atrial Thrombus in Juvenile Mitral Stenosis

A 13-year-old boy presented with rapidly progressive dyspnea and orthopnea over 2 days. He had a history of exertional dyspnea since early childhood but did not seek medical advice. On physical examination, there was sinus tachycardia, mid diastolic murmur at apex, loud second heart sound (S2) and bilateral lungs crepitation. Antistreptolysin O titer, erythrocyte sedimentation rate and C-reactive protein were within normal limit. Echocardiogram revealed thickened and doming anterior mitral leaflet with decreased E-F slope, severe mitral stenosis (estimated mitral valve area by planimetry = 0.6 cm.sq.), and severe pulmonary artery hypertension.
Source: The Journal of Pediatrics - Category: Pediatrics Authors: Tags: Insights and Images Source Type: research