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General Medicine General d9d32e64

A 40 year old female presented with dyspnoea on exertion grade and palpitations. ECG showed atrial fibrillation with fast ventricular rate. Echocardiography shows severe mitral stenosis with left atrial appendage clot. Which of the following is not advised?

A
Diltiazen to control ventricular rate
B
Start warfarin and follow-up with repeat echocardiography
C
EC followed by percutaneous balloon mitral valvuloplasty
D
Open mitral commissurotomy with clot removal

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