A patient underwent replacement of aortic valve with the mechanical prosthesis 15 years ago. Recent trauma of the upper limb required temporary reduction of anticoagulation therapy.
The patient was admitted for worsening dyspnea and suspicion of pneumonia. Tachypnea, dyspnea, the necessity of O2 support. Auscultation revealed bilateral crackles in basal segments.
Admission echocardiography findings: gradient across aortic valve exceeded 80 mmHg, By suspicion of valve thrombosis IV thrombolytics were given with subsequent drop of the gradient to 45 mmHg.
Check sonography was performed next day: