Mechanical Mitral Valve Thrombosis Treated With Fibrinolysis

Abstract

A 27-year-old lady presented to the emergency department with a 3-week history of worsening shortness of breath. Her past history was significant for mechanical mitral valve replacement 6 months prior for rheumatic mitral stenosis. She had recently been non-compliant with international normalised ratio checks for warfarin dosing in the setting of local lockdown for the COVID-19 pandemic. On examination, there was loss of mitral valve click with associated elevated jugular venous pressure, right ventricular heave, loud P2, and bi-basal crepitations.