The article, "chief complaint: paroxysmal respiratory distress caused by light exertion" was reviewed.This research article is a single center experience to evaluate paroxysmal respiratory distress caused by light exertion.The patient suffered from combined valvular disease and underwent double valve replacement in which 2 non-abbott valves were implanted.On an unknown date, two 8mm amplatzer vascular plug ii were implanted due to paravalvular leak (pvl).The pvl was almost resolved and the patient reported improved conditions.After an unspecified amount of time, respiratory distress with light exertion and acute pulmonary edema developed again.The symptoms were temporarily improved with diuretic control, however respiratory distress deteriorated further.Uncompensated heart failure caused by mitral valve insufficiency was diagnosed.It was diagnosed that the leaflet had inadequate opening due to interference by the implanted plug, which was protruding into the left ventricular outflow tract.Cardiac computed tomography (ct) was negative for thrormbus, pannus, and vegetation.Redo mitral valve procedure was recommended, however the patient did not consent and was transferred to another facility for conservative cares.[the author of this article is akira fujii, md, hoshinookashinzo kekkan clinic, 1 chome-5-5 higashiishii, matsuyama, ehime 790-0932, japan].
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