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Case Presentation A 67 year-old Cantonese speaking male was seen at primary care clinic with complaints of dyspnea on exertion and decreased exercise tolerance. His medical history includes rheumatic heart disease, tricuspid regurgitation, tricuspid repair three months ago, mitral regurgitation, mitral valve replacement with a bioprosthetic valve three months ago, atrial fibrillation on anticoagulation therapy, permanent pacemaker implantation, severe pulmonary hypertension, benign prostatic hypertrophy, gastroesophageal reflux disease, and iron deficiency anemia. The patient reports that in the last two weeks, he has been unable to ambulate more than two blocks limited by shortness of breath, which represents an acute change. He also complains of bilateral lower extremity edema. He reports that two weeks after his mitral valve replacement, his exercise tolerance was dramatically improved, and he was able to ambulate more than two blocks without difficulty.

Primary Care Follow Up Post Mitral Valve Surgery at Ambulatory Clinic