Hypothyroidism and Double Mitral Lesion in Antiphospholipid Syndrome During Pregnancy: A Case Report

José Manuel Madrazo Cabo; Ania Villavicencio Flores; Paulina Chagollán Gudiño; Nuvia Adriana Monter Valera; Jose Antonio Velasco Bárcena; Virginia Sedeño Monge

doi:10.12659/AJCR.945578

17 April 2025 : Case report Mexico

Hypothyroidism and Double Mitral Lesion in Antiphospholipid Syndrome During Pregnancy: A Case Report

Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Adverse events of drug therapy, Clinical situation which can not be reproduced for ethical reasons, Rare coexistence of disease or pathology

José Manuel Madrazo Cabo^{A 1,2}, Ania Villavicencio Flores^{BE 2}, Paulina Chagollán Gudiño^{BE 2}, Nuvia Adriana Monter Valera^{F 2}, Jose Antonio Velasco Bárcena^{D 3}, Virginia Sedeño Monge^{E 2*}

DOI: 10.12659/AJCR.945578

Am J Case Rep 2025; 26:e945578

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Table 3. Normal range of echocardiographic measurements.

	Units	Normal range for women	Calculated average for the patient
Interventricular septal thickness in diastole	mm	6–9	8.8
Posterior wall thickness in diastole	mm	6–9	8.5
Left ventricular diastolic diameter	mm	37–52	49
Left ventricular systolic diameter	mm	21–34	30
Relative wall thickness		0.22–0.42	0.35
Net mass	grs	67–162	146
Left ventricular mass index	grs/m	43–95	83
Left ventricular end-diastolic volume	ml	46–106	70.4
Left ventricular end-diastolic volume index	ml/m	29–61	44
Left ventricular end-systolic volume	ml	14–42	25.8
Left ventricular end-systolic volume index	ml/m	8–24	16.2
Left ventricular ejection fraction	%	54–74	63
Indexed left atrial volume	ml/m	16–34	52
Left atrial area	cm	<20	27
of the mitral valve. Normal pattern		1–2	1.1
of the mitral valve. Grade I delayed relaxation		<1
of the mitral valve. Grade II pseudonormalization		1–1.5
of the mitral valve. Grade III restrictive pattern		>2
	m/seg	0.57–1.7	1.7
	mmHg	<10	6
	cm	>3	2.91
	mm	26	19
	mm	34	22
	mm	29	20
	mm	30	24
	mm	22–36	26
	mm	18–28	22
Right ventricular wall thickness	mm	<5	4
Basal diameter of the right ventricle	mm	25–41	35
Mean diameter of the right ventricle	mm	19–35	24
Longitudinal diameter of the right ventricle	mm	59–83	77
Right ventricular diastolic area	cm	8–20	20
Right ventricular systolic area	cm	3–11	11
Right ventricular fractional shortening	%	>35	45
of the tricuspid valve. Normal pattern		>0.8	1
of the tricuspid valve. Grade I delayed relaxation		<0.8
of the tricuspid valve. Grade IIpseudonormalization		0.8–2.1
of the tricuspid valve. Grade III restrictive pattern		>2.1
Tricuspid annular plane systolic excursion	mm	>17	–
Indexed right atrial volume	ml/m	21–27	20
Right atrial area	cm	<18	16
Maximum velocity of flow through the pulmonaryvalve	m/s	1.0–1.7	1.2
Mean pulmonary gradient	mmHg	<40	3
Tricuspid regurgitation velocity	m/s	2.8–2.9	3
Right ventricular and/or pulmonary artery systolicpressure	mmHg	<36	42
Right ventricular outflow tract diameter	mm	<30	28
Pulmonary artery trunk diameter	mm	<30	27
Inferior vena cava diameter	mm	<21	20
Maximum systolic velocity of the tricuspid annulus by Tissue Doppler	cm/seg	>9.5	17
Maximum E’ wave velocity of the mitral annulus byTissue Doppler	cm/seg	≥8	8
Maximum A’ wave velocity of the mitral annulus byTissue Doppler	cm/seg	<8	15

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Hypothyroidism and Double Mitral Lesion in Antiphospholipid Syndrome During Pregnancy: A Case Report

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