CHRONIC MITRAL INSUFFICIENCY WITH POOR ADHERENCE TO MEDICAL TREATMENT FOR HEART FAILURE - CASE REPORT

INTRODUCTION AND OBJECTIVE: Chronic mitral insufficiency is a valve disease with slow installation that progressively leads to cardiac remodeling and dilated cardiomyopathy. Patients without response to clinical treatment may require prosthetic valve in the presence of symptoms of heart failure and reduced ejection fraction. Surgical patients require monitoring for treatment of ventricular dysfunction, which isn’t surgically solved. The objective of this study is to report a case of Chronic Mitral Insufficiency with poor adherence to medical treatment for heart failure. METHOD: For this case was used the medical records and patient interview after consent and literature review. RESULTS AND CONCLUSIONS: Report the case of a female patient, 60 years old, hypertension and heart valve disease, accompanied by family health unit since 1996, with dyspnea history at the slightest effort, poor treatment adherence and depressive disorder. It is submitted to mitral valve replacement 28 years ago (bioprosthesis) and new exchange 18 years later, showing currently worsening dyspnea framework and irregular use of medications. The patient presents dyspnea at the slightest effort with signs of hypervolemia. Echocardiogram ejection fraction of 62%; bioprosthesis in mitral position dysfunctional; double aortic dysfunction (slight stenosis and moderate insufficiency); tricuspid moderate insufficiency and Pulmonary Artery Hypertension. Showing indication of further intervention to valve exchange. The lack of adherence to treatment and periodic monitoring of ventricular dysfunction by the heart-valve-diseased patient's primary care leads to worsening of this case, late diagnosis of complications and increase the cost of treatment to health services.