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乳头肌破裂导致严重急性二尖瓣反流引起的咯血和单侧肺浸润

Hemoptysis and Unilateral Pulmonary Infiltrates due to Severe Acute Mitral Regurgitation from Papillary Muscle Rupture.

作者信息

Wieckowska Joanna, Diloreto Nicholas, Hood Shannon, Chojnacki Isabella, Zakri Dalia

机构信息

Department of Pulmonary/Critical Care, Ascension Genesys Hospital, Grand Blanc, MI, USA.

Department of Graduate Medical Education, Michigan State University School of Osteopathic Medicine, Lansing, MI, USA.

出版信息

Case Rep Pulmonol. 2024 Jan 9;2024:5534308. doi: 10.1155/2024/5534308. eCollection 2024.

Abstract

Acute mitral regurgitation typically presents with dyspnea, chest pain, and hemodynamic instability. It is an uncommon cause of hemoptysis. We present a case of a patient presenting with dyspnea and hemoptysis without hemodynamic instability along with right-sided infiltrate on chest radiography a few days after an acute inferolateral STEMI who was found to have posterior papillary muscle rupture resulting in acute mitral regurgitation. Our case illustrates that the aforementioned symptoms and signs should raise concern for acute mitral regurgitation and prompt cardiac evaluation in the appropriate clinical setting as they may mimic acute pulmonary processes and delay critical diagnosis and treatment.

摘要

急性二尖瓣反流通常表现为呼吸困难、胸痛和血流动力学不稳定。它是咯血的罕见原因。我们报告一例患者,在急性下壁心肌梗死伴ST段抬高几天后,出现呼吸困难和咯血,但无血流动力学不稳定,胸部X线显示右侧浸润影,经检查发现为后乳头肌破裂导致急性二尖瓣反流。我们的病例表明,上述症状和体征应引起对急性二尖瓣反流的关注,并在适当的临床环境中促使进行心脏评估,因为它们可能类似于急性肺部疾病,从而延误关键的诊断和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/151c/10791320/718dc4058184/CRIPU2024-5534308.001.jpg

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