It can be made from;
*past h/o valvular heart disease> valve replacement.
*present c/o signs&symptoms of anaemia.
*lab evidence of haemolysis which includes:
-s.lactate dehydrodehydrogenase is elevated.
-pereohral smear will show increase -retics count with prescrnce of -schistocyte
-s.unconjugated bilrubin is raised
-increde urinary urobilinogen
-reduced plasma haptoglobulin.
*echo evaluation of the prosthetic valve.