Cardiovascular Physiotherapy After Mitral Valve Replacement for Rheumatic Heart Disease: A Case Report

Abstract

Background: Rheumatic heart disease can cause severe valvular abnormalities requiring mitral valve replacement and early postoperative rehabilitation. Detailed descriptions of staged physiotherapy during the immediate postoperative period remain limited.
Objective: To describe physiotherapy assessment, intervention, clinical progression, and documented outcomes following mitral valve replacement in a patient with rheumatic heart disease.
Methods: This descriptive case report involved a 54-year-old woman who underwent mitral valve replacement on 29 August 2025. Five physiotherapy sessions were documented from 31 August to 5 September 2025. Interventions progressed according to the documented clinical condition, from positioning, passive ankle pumping, and passive knee range of motion to breathing and coughing exercises, sitting, active assisted knee exercise, standing, and active ankle pumping.
Results: Glasgow Coma Scale increased from 8 to 15. Oxygen saturation increased from 97% to 99%, while respiratory rate decreased from 27 to 25 breaths/minute. The Barthel Index increased from 5 to 11, Borg CR10 decreased from 3 to 1, Hamilton Anxiety Rating Scale decreased from 29 to 22, and metabolic equivalents increased from 1 to 2. New York Heart Association classification changed from class II to III, whereas Killip classification remained class I. No adverse events were reported. No follow up or discharge information after 5 September 2025 was available.
Conclusion: Clinical and functional changes were documented during early postoperative recovery while staged physiotherapy was provided alongside surgical and medical management. This single case cannot establish treatment effectiveness or causal attribution.