Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
Intern Med. 2021 May 1;60(9):1417-1421. doi: 10.2169/internalmedicine.5502-20. Epub 2020 Dec 7.
An 80-year-old woman with acute posterolateralmyocardial infarction, cardiogenic shock, and acute heart failure was admitted to our hospital. Transthoracic echocardiography (TTE) showed dysfunction of the left ventricular inferolateral wall motion and severe mitral valve regurgitation (MR). Emergency coronary angiography revealed triple-vessel stenosis. We performed transesophageal echocardiography in the catheter room to diagnose the cause of MR. Severe tenting of the mitral valve and no rupture of the papillary muscles were revealed. We considered ischemic MR likely to improve with revascularization and performed percutaneous coronary intervention. Subsequently, the patient's circulatory dynamics rapidly stabilized, and MR was significantly improved on follow-up TTE.
一位 80 岁女性，因急性后外侧壁心肌梗死、心源性休克和急性心力衰竭入院。经胸超声心动图（TTE）显示左心室下外侧壁运动功能障碍和严重二尖瓣反流（MR）。紧急冠状动脉造影显示三血管狭窄。我们在导管室进行经食管超声心动图以诊断 MR 的病因。发现二尖瓣严重幕状运动，但乳头肌无破裂。我们考虑缺血性 MR 可能随着血运重建而改善，并进行了经皮冠状动脉介入治疗。随后，患者的循环动力学迅速稳定，随访 TTE 显示 MR 明显改善。
