April 2022 Br J Cardiol 2022;29:77–8 doi:10.5837/bjc.2022.014
Kristen Westenfield, Shannon Mackey-Bojack, Yale L Wang, Kevin M Harris
Case A woman in her late 80s with a past medical history of severe aortic stenosis, rheumatic fever, coronary artery disease with prior myocardial infarction, and atrial flutter, presented with worsening shortness of breath, chest pain and near syncope. Prior to presentation she was undergoing evaluation for transcatheter aortic valve replacement (TAVR). Given the escalation of her symptoms, she was admitted for expedited evaluation. Upon admission, she was haemodynamically stable with a harsh systolic murmur. As a prelude to TAVR, coronary angiography was performed. The angiogram was technically challenging due to heavily calcified and tortu
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