Severe pulmonary hypertension caused by untreated mitral stenosis. It still happens in the XXI century

We present a case of a 58 years old patient with extremely severe mitral stenosis. Several years ago she denied surgical treatment despite qualification by cardiologists. At present hospitalisation mitral valve area was calculated as 0.5 cm(2) with systolic right ventricular systolic pressure of 125 mmHg. Right ventricle was hypertrophied and extremely enlarged as well as both atria. Surprisingly she was still in sinus rhythm and had no thrombi in the left atrium. Patient died before scheduled surgery because of cardiac decompensation and renal insufficiency.