Severe mitral stenosis with atypical presentation: hemorrhagic pleural effusion--a case report and literature review.

Mitral stenosis is a well-described valvular heart disease. We report a 68-year-old patient with an unusual presentation of mitral stenosis. He presented with recurrent episodes of hemorrhagic pleural effusion. Afterwards, an extensive atrial thrombosis complicated his course of illness. We will discuss how the clinical presentation of mitral stenosis is mainly dictated by the underlying pathophysiology of the disease. Also, the need for anticoagulation in the setting of mitral stenosis is often linked to the presence of atrial fibrillation. We will discuss the independent risk factors for thromboembolism in the setting of mitral stenosis. Finally, a review of the current recommendation for anticoagulation is conferred.

Papillary fibroelastoma involving the left ventricular wall.

A 71-year-old white woman presented to her primary care physician for a routine visit and was found to have a new, previously undocumented cardiac murmur. A subsequent transthoracic echocardiogram revealed a 1 cm mobile mass arising from the lateral free wall of the left ventricle. Transesophageal echocardiography later confirmed these findings. The patient underwent a left ventriculotomy and excision of a.7 cm friable mass, which was later identified as a papillary fibroelastoma (PFE) by routine histopathologic studies. We present this unique case ith a review of the literature.