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case_images: 12 Lead electrocardiogram.
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case_images: Her electrocardiogram shows right axis deviation, absent R-wave progression in the chest leads and course atrial fibrillation (Figure 1).
case_images: Posteroanterior Chest X ray.
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case_images: Postero-anterior chest x ray showed cardiac apex pointing to the right, right-sided aortic arc and lower level right hemidiaphragm presents compared to the left (Figure 2).
case_images: Pre-procedure transesophageal echocardiography.
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case_images: Transthoracic and trans-esophageal echocardiography showed mirror image dextrocardia and morphologic changes of rheumatic heart disease involving the mitral and aortic valves, severe mitral stenosis with mitral valve area of 0.7 cm2 and transmitral mean gradient of 13 mmHg, Mild Mitral Regurgitation, Mild Aortic Regurgitation and Moderate Pulmonary hypertension with no left atrial thrombus (Figure 3).
case_images: Coronary angiogram of the left (A) and right (B) coronary arteries.
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case_images: Coronary angiography shows normal coronary arteries (Figure 4A and B).
case_images: Fluoroscopic image of balloon dilatation of the mitral valve.
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case_images: We used reverse loop technique which makes the axis better (Figure 5).
case_images: Post-procedure transthoracic echocardiography CW Doppler across the mitral valve.
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case_images: The post procedure echocardiogram is attached (Figure 6).