Abstract

INTRODUCTION: Lutembacher syndrome (LS) is an uncommon cardiac abnormality characterized by any association of a congenital or iatrogenic atrial septal defect (ASD) and a congenital or acquired mitral stenosis (MS). The hemodynamic effects of this syndrome are a result of the interplay between the relative effects of the ASD and MS. CASE REPORT: A 35-year-old woman presented to the cardiology clinic with a 1-month history of easy fatigability, exertional dyspnea, and productive cough with whitish phlegm. She has no edema, orthopnea, paroxysmal nocturnal dyspnea, or fever. Two weeks before admission, she developed palpitation and still with persistence of symptoms. She sought consultation and was prescribed with clopidogrel 75 mg one tablet once a day, sildenafil 100 mg one tablet once a day, and verapamil 40 mg one tablet once a day, which provided relief. She has no history of hypertension, diabetes, cerebrovascular disease, coronary artery disease, or thyroid or renal disease. She is a nonsmoker and an occasional alcoholic drinker. On general physical examination, blood pressure was 120/80 mm Hg; cardiac rate, 72 beats per minute; and respiratory rate, 20 cycles per minute. She was afebrile and had distended jugular veins with rales at the left lung base. Abdominal examination revealed neither organomegaly nor shifting dullness. There was neither cyanosis nor pedal edema.

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