case_images: PMC10892377_01
case_images: EKG showing atrial flutter with variable block
case_images: cureus-0016-00000052903-i01.jpg
case_images: PMC10892377_01_cureus-0016-00000052903-i01.jpg
case_images: FIG1
case_images: EKG revealed atrial flutter with a variable block (Figure 1), and the chest X-ray showed cardiomegaly, vascular congestion, and small bilateral pleural effusion (Figure 2).
case_images: CXR showing cardiomegaly, vascular congestion, and small bilateral pleural effusion. CXR: Chest X-ray
case_images: cureus-0016-00000052903-i02.jpg
case_images: PMC10892377_01_cureus-0016-00000052903-i02.jpg
case_images: FIG2
case_images: EKG revealed atrial flutter with a variable block (Figure 1), and the chest X-ray showed cardiomegaly, vascular congestion, and small bilateral pleural effusion (Figure 2).
case_images: Transthoracic echocardiography parasternal long-axis view showing moderate to severe AR. AR: Aortic regurgitation
case_images: cureus-0016-00000052903-i03.jpg
case_images: PMC10892377_01_cureus-0016-00000052903-i03.jpg
case_images: FIG3
case_images: AR (Figure 3), mild-moderate aortic stenosis (AS), moderate MS with doming of anterior mitral leaflet (Figures 4-6), severe MR (Figure 7), and severe TR (Figure 8). After normalization of kidney function and optimal diuresis, he was initiated on goal-directed medical therapy (GDMT) for heart failure with metoprolol succinate, lisinopril, spironolactone, and dapagliflozin.
case_images: Transthoracic echocardiography parasternal long-axis view showing hockey stick of anterior and posterior mitral valve leaflets
case_images: cureus-0016-00000052903-i04.jpg
case_images: PMC10892377_01_cureus-0016-00000052903-i04.jpg
case_images: FIG4
case_images: AR (Figure 3), mild-moderate aortic stenosis (AS), moderate MS with doming of anterior mitral leaflet (Figures 4-6), severe MR (Figure 7), and severe TR (Figure 8). After normalization of kidney function and optimal diuresis, he was initiated on goal-directed medical therapy (GDMT) for heart failure with metoprolol succinate, lisinopril, spironolactone, and dapagliflozin.
case_images: Transthoracic echocardiography M-mode showing E-F slope flattening
case_images: cureus-0016-00000052903-i05.jpg
case_images: PMC10892377_01_cureus-0016-00000052903-i05.jpg
case_images: FIG5
case_images: AR (Figure 3), mild-moderate aortic stenosis (AS), moderate MS with doming of anterior mitral leaflet (Figures 4-6), severe MR (Figure 7), and severe TR (Figure 8). After normalization of kidney function and optimal diuresis, he was initiated on goal-directed medical therapy (GDMT) for heart failure with metoprolol succinate, lisinopril, spironolactone, and dapagliflozin.
case_images: Transthoracic echocardiography continuous wave Doppler showing moderate MS. MS: Mitral stenosis
case_images: cureus-0016-00000052903-i06.jpg
case_images: PMC10892377_01_cureus-0016-00000052903-i06.jpg
case_images: FIG6
case_images: AR (Figure 3), mild-moderate aortic stenosis (AS), moderate MS with doming of anterior mitral leaflet (Figures 4-6), severe MR (Figure 7), and severe TR (Figure 8). After normalization of kidney function and optimal diuresis, he was initiated on goal-directed medical therapy (GDMT) for heart failure with metoprolol succinate, lisinopril, spironolactone, and dapagliflozin.
case_images: Transthoracic echocardiography four-chamber view showing severe MR. MR: Mitral regurgitation
case_images: cureus-0016-00000052903-i07.jpg
case_images: PMC10892377_01_cureus-0016-00000052903-i07.jpg
case_images: FIG7
case_images: AR (Figure 3), mild-moderate aortic stenosis (AS), moderate MS with doming of anterior mitral leaflet (Figures 4-6), severe MR (Figure 7), and severe TR (Figure 8). After normalization of kidney function and optimal diuresis, he was initiated on goal-directed medical therapy (GDMT) for heart failure with metoprolol succinate, lisinopril, spironolactone, and dapagliflozin.
case_images: Transthoracic echocardiography four-chamber view showing severe TR. TR: Tricuspid regurgitation
case_images: cureus-0016-00000052903-i08.jpg
case_images: PMC10892377_01_cureus-0016-00000052903-i08.jpg
case_images: FIG8
case_images: AR (Figure 3), mild-moderate aortic stenosis (AS), moderate MS with doming of anterior mitral leaflet (Figures 4-6), severe MR (Figure 7), and severe TR (Figure 8). After normalization of kidney function and optimal diuresis, he was initiated on goal-directed medical therapy (GDMT) for heart failure with metoprolol succinate, lisinopril, spironolactone, and dapagliflozin.