A woman in her 80s with a history of severe symptomatic aortic stenosis and recent transfemoral transcatheter aortic valve replacement (TAVR) presented with a change in mental status characterized by lethargy, blurred vision, nausea, and diarrhea. Her other comorbidities included persistent (chronic) atrial fibrillation (AF), moderate mitral stenosis (peak and mean transvalvular gradients of 12 mm Hg and 5 mm Hg, respectively, with valve area 1.4 cm2) and left intraventricular conduction delay.
Raffel KE, Goldschlager N. Abnormal Electrocardiogram in a Woman With Atrial Fibrillation and Recent Care Transition. JAMA Intern Med. Published online February 13, 2017. doi:10.1001/jamainternmed.2016.9356