Pulmonary thromboembolism in a patient with rheumatic mitral valve stenosis: a fortuitous association?

In this case report, we illustrate our experience with a patient simultaneously suffering from rheumatic mitral valve stenosis and pulmonary thromboembolism who successfully underwent mitral valve replacement and pulmonary thromboendarterectomy. Physical examination and transthoracic echocardiography revealed mitral stenosis, atrial fibrillation, and a large thrombus in the left atrium. The preoperative workup led to the diagnosis of pulmonary thromboembolism. This case emphasizes the importance of preoperative evaluation for pulmonary thromboembolism in symptomatic patients with mitral valve stenosis and atrial fibrillation.