Outcome and follow up
During follow-up, despite the treatment of heart failure with optimal
medical therapy with foundational therapy and cardiac rehabilitation
among others, his mitral and tricuspid regurgitations progressed to a
worse severe grade, preventing an improvement in the symptoms reported
by the patient, with a gradual increase in symptoms, which is why after
holding a new medical meeting, it was considered that he was a candidate
for mitral valve replacement and tricuspid valve plasty. Besides, a
myocardial biopsy was performed during the surgery.
Although, in an interesting way, the myocardial biopsy revealed
endocardial and subendocardial fibrosis with anisonucleosis of the
cardiomyocytes, also with altered architecture from the myocardial
fibres (Figure 3). Currently the patient is receiving optimal medical
therapy for his heart failure and is undergoing cardiac rehabilitation.