A mobile echodense mass on pre-TAVI echocardiography: strategies for stroke prevention
Mrs. YM, 83 years old presented with a one-year history of increasing shortness of breath. Her other background history included hypertension, alpha-thalassaemia and polymyalgia rheumatica for which she had been on long-term steroids. On clinical examination there was a harsh ejection systolic murmur with a quiet second heart sound and echocardiography confirmed severe aortic stenosis. Prior to her presentation to hospital she had been performing all activities of daily living independently. In view of her progressive symptoms, she was referred for consideration of aortic valve intervention. Work up and further assessment included coronary and iliofemoral angiography, carotid duplex ultrasound, lung function tests and a CT scan of her iliofemoral vasculature.