Abstract
The Communication describes a case study of a patient with progressive bilateral heart failure at atrial fibrillation with rapid ventricular response. Transthoracic echocardiography found dilated, diffusely hypokinetic left ventricle with severe systolic dysfunction, significant mitral regurgitation and signs of pulmonary hypertension.
The condition was initially assessed as tachycardia-induced cardiomyopathy. Early recurrence of arrhythmia occurred after electric cardioversion.
With the control of the heart rate and heart failure therapy the clinical condition of patient improved. Control transthoracic and transesophageal echocardiography showed improvement in left ventricular systolic function but also the persistence of significant mitral regurgitation.
This severe mitral regurgitation was recognised as a primary cause of heart failure, despite only mild morphological changes at the valve. The patient was indicated for mitral valve replacement.