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This presentation strongly suggests left-sided heart failure secondary to chronic rheumatic heart disease, which characteristically causes mitral stenosis due to fused commissures

Combining NAD+ and glutathione may support energy production, detox pathways, and metabolic health

Caffeine's Effects on Glutathione Levels Research indicates that moderate coffee consumption may actually increase plasma glutathione levels

[Google Scholar] 874.Kajita M., Kato T., Yoshimoto T., Masuda K

reports 8 , 2926, (2018)

Kretschmar M, Klinger W (1990)
