Severe aortic regurgitation and heart failure

A woman in her 70s was evaluated for fatigue and chest tightness for 4 months and oedema of both lower extremities for 1 month. She denied any medical history and family history of heart disorders. ECG showed normal QRS voltages with intraventricular block and left ventricular (LV) hypertrophy. Echocardiography showed severe aortic regurgitation (AR), asymmetric LV hypertrophy (maximum wall thickness of the septum 15 mm and 11 mm of the posterior wall) and normal LV size and ejection fraction of 60%. Transcatheter aortic valve replacement (TAVR) was successfully performed, and myocardial biopsy was made in the patient considering severe heart failure (HF) symptoms and high EuroSCORE of 22.5%. However, previous HF …