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Elevated preprocedural CRP is not associated with increased risk for CI-AKI in patients undergoing PCI
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Case History :

A 66-year-old woman presented with a history of anginal pain and palpitations. She was long known to have congenital heart disease and was generally well with out requiring any medications. She has a history of diabetes and hypertension since the past ten years and is on insulin. Around 2 years back she had developed dyspnoea, which was more on lying down and edema in the legs, and had atrial arrhythmias at approximately the same time. This continued later intermittently. Responded well to treatment.

On examination she was apparently well. She had a Right sided heart and a left sided liver. The B.P was 170/86 mmHg. Pulse 68/minute and regular and a mildly displaced apex on auscultation the Apical fourth heart sound and systolic murmur at the apex with a Loud single second heart sound.

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Investigation Reports :

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Discussion :

A 66-year-old woman with congenitally corrected transposition and dextrocardia. She gives a one-year history of episodic biventricular failure and episodic atrial tachycardias associated with angina. She has responded well to medical management. She was decided for a surgical approach, based primarily on a TEE showing quite severe systemic tricuspid regurgitation. This woman did have surgery. Her systemic tricuspid valve was replaced with a 29 mm St. Jude mechanical valve. Medtronic DDD pacemaker leads were placed epicardially. Her postoperative course was smooth, apart from the development of complete heart block, and episodes of asymptomatic atrial fibrillation.

Has postoperative echo showed a grade 2 systemic RV with a normal mechanical valve and a normally functioning DDD pacemaker She was discharged on coumadin, enalapril, simvastatin, atenolol, ranitidine, digoxin and insulin?