CASE PRESENTATION
An 88-year-old gentleman presented to our center with progressive dyspnea, fatigue and chills since a month ago and loss of appetite and weight in the last two weeks. At presentation, blood pressure was 126/48, heart rate was 80 beats/min, respiratory rate was 16 breaths/min, O2 saturation was 92% in ambient air and temperature was 37.8ﹾ C, III/VI systolic and diastolic murmurs in right sternal border, decreased lungs sounds in both lungs and peripheral edema of both lower limbs were detected in his physical examination.
He lived alone and did his own work until last month. He had history of hypertension and also aortic valve (AV) replacement with a bioprosthesis 18 years ago because of severe stenosis. Six months ago he was diagnosed with Covid-19 pneumonia and the symptoms recovered in a month. His medications include aspirin, furosemide and valsartan.
Last month, he was admitted in another center with dyspnea where found to have degenerative changes of aortic bioprosthesis. He had acute kidney injury there and was discharged with creatinine 2.3mg/dl.