Patient: Examination and laboratory tests: Ultrasound findings: 1. Enlarged left atrium: The left ventricular cavity is normal in size. The left ventricular wall was not thickened and the contractile activity was slightly diminished. 2, mitral valve thickening and brightening, restricted opening of anterior and posterior leaflets, opening in a domed shape. m-type: mitral valve anterior and posterior leaflets show rampart-like changes, anterior and posterior leaflets show isotonic motion. cdfi: see mitral valve orifice diastolic bias high velocity stenotic flow velocity, showing red and yellow predominant multicolored mosaic. Mitral valve hemifacial area PHT method: 1,03 CM squared. 3, no abnormal aortic valve shape and unrestricted opening; CDFI: see aortic regurgitation (mild). The aortic internal diameter was not widened and the anterior and posterior wall activity was good.4 The right atrium was large, the right ventricular internal diameter was normal, the pulmonary artery was not widened, and the continuous Doppler estimated the pulmonary artery systolic pressure to be approximately 65 mmHg according to moderate tricuspid regurgitation. Ultrasound impression: wind heart 1, mitral stenosis (moderate) 2, large double atrium with slightly reduced left ventricular systolic activity. 3, aortic valve insufficiency (mild) 4, moderate tricuspid regurgitation with pulmonary hypertension (moderate) Treatment: Currently taking digoxin, aspirin enteric capsules, hydrochlorothiazide tablets, spironolactone tablets, metoprolol succinate extended-release tablets, trimetazidine hydrochloride tablets, and Yixinshu capsules. Medical history: It has been several years. It used to be fine, but now I have severe shortness of breath when going up a staircase, fear of cold, poor sleep, etc. What treatment does the doctor recommend? Xiong Lihua, Department of Cardiothoracic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University: Your disease needs to be treated with surgery as soon as possible, because the valve has moderate stenosis and pulmonary hypertension is obvious. The most common pathological change caused by rheumatic heart disease is the thickening of the valve fibrosis, plaque formation or even calcification, junctional fusion, resulting in narrowing of the valve, forming a simple mitral stenosis. In about 1/3 of cases, mitral stenosis is associated with insufficiency of closure. The lesions are mild and may be asymptomatic in those with good cardiac function. Those with more severe or prolonged lesions may have symptoms such as weakness, palpitations, and shortness of breath after exertion. If the heart is enlarged, the surgery should be performed under extracorporeal circulation, and if there is tricuspid valve insufficiency, it should be corrected at the same time. Your condition requires surgery to solve the problem. Drugs may temporarily improve heart function, but will not reverse the course of the disease. If minimally invasive is needed, we can do an anterolateral incision, which is more effective in young women. At this time, your examination requires mitral valve replacement and tricuspid valve exploration, which may require plastic surgery. Given your age, it is best to know if there are any problems with the coronary arteries of the heart before surgery.