Bekiaridou Alexandra, Kartas Anastasios, Moysidis Dimitrios V, Papazoglou Andreas S, Patsiou Vasiliki, Baroutidou Amalia, Kamperidis Vasileios, Giannakoulas George
First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
J Cardiol Cases. 2022 Apr 22;26(2):130-133. doi: 10.1016/j.jccase.2022.03.020. eCollection 2022 Aug.
This is a case of a 70-year-old male patient with a history of degenerative mitral valve disease who presented to the emergency department with progressively worsening dyspnea. Prominent findings were rapid atrial fibrillation and unilateral pulmonary edema. Transthoracic and transesophageal echocardiography revealed chordal rupture-related severe-eccentric mitral regurgitation. The patient underwent surgical mitral valve repair.
•To acknowledge that the clinical presentation may not be as dramatic when acute mitral regurgitation (MR) is superimposed on chronic MR, due to the increased left atrium compliance•To bear in mind that eccentric jets of severe MR can cause unilateral pulmonary infiltrates, mimicking a primary pulmonary process•To remind that rapid atrial fibrillation might be the result rather than the cause of acute cardiac decompensation.
这是一名70岁男性患者的病例，有退行性二尖瓣疾病史，因进行性加重的呼吸困难就诊于急诊科。突出表现为快速房颤和单侧肺水肿。经胸和经食管超声心动图显示腱索断裂相关的严重偏心性二尖瓣反流。患者接受了二尖瓣修复手术。
•认识到当急性二尖瓣反流（MR）叠加在慢性MR上时，由于左心房顺应性增加，临床表现可能不那么显著•记住严重MR的偏心性射流可导致单侧肺部浸润，类似于原发性肺部疾病•提醒快速房颤可能是急性心脏失代偿的结果而非原因。
