Forty-Eight-Year Functionality of Björk-Shiley Aortic and Mitral Valves in One Patient.

The Björk-Shiley mechanical valve was the first tilting-disc valve used to replace aortic and mitral valves. We present a case of a double aortic and mitral valve replacement with both valves functioning properly over 48 years after the original implantation. Minimal negative changes are evident in either valve despite the progression of cardiac abnormalities, including the development of a dilated cardiomyopathy associated with chronic systolic and diastolic heart failure and the implantation of an implantable cardioverter defibrillator (ICD). Our patient's case appears to be the most significant example of double-valve replacement longevity described in the literature.

ECG Abnormalities Preceding Structural Changes of Apical Hypertrophic Cardiomyopathy by up to 10 Years.

A 48-year-old man with hypertension and hypercholesterolemia was referred with an abnormal ECG showing signs of myocardial ischemia and structural change consistent with ventricular hypertrophy. Upon further workup with MRI, echocardiogram, and exercise stress test with perfusion images, it was determined that the man had no cardiac abnormalities. Ten years later, the patient developed structural changes consistent with the abnormal ECG. The patient was diagnosed with apical hypertrophic cardiomyopathy and was treated appropriately with an automatic implantable cardiac defibrillator. The objective of this clinical case report is to highlight this unusual incident where ECG changes preceded structural changes within the heart by 10 years.