Document Detail


Downgrading mitral regurgitation in the echo laboratory: a case of rheumatic mitral restricted motion unmasked by emotional stress.
MedLine Citation:
PMID:  21297486     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We report the case of a 76-year-old woman with mild-to-moderate mitral regurgitation due to rheumatic disease, severe dyspnoea, pulmonary hypertension and a recent episode of heart failure with paroxysmal atrial fibrillation. Transthoracic echocardiography at rest showed a mild-to-moderate mitral regurgitation, which was unable to justify the acute worsening of heart failure symptoms. During transesophageal echocardiography (TEE), deep anxiety induced sinus tachycardia and high SBP followed by pulmonary subedema. The TEE study ascertained a new-onset transient severe mitral regurgitation induced by stress and tachycardia. We speculate that the mechanism underlying the increasing of mitral regurgitation was related to the restricted motion of the posterior leaflet worsened by tachycardia. A further TEE, performed in the operating room under general anesthesia, thus without the emotional involvement of the patient, was not able to provoke a heart failure, even after dobutamine infusion, thus, downgrading the anatomical and functional mitral regurgitation severity.
Authors:
Antonio Grimaldi; Luisa De Gennaro; Natale Daniele Brunetti; Enrico Ammirati; Francesco Arioli; Iryna Arendar; Annalisa De Concilio; Ottavio Alfieri; Giovanni La Canna
Related Documents :
3429936 - Transoesophageal echocardiographic monitoring of left ventricular function.
21882486 - Idiopathic ventricular tachycardia originating from the posteroseptal mitral annulus: a...
22275196 - In the spotlight: cardiovascular engineering.
2998796 - Cardiac function in acute hypothyroidism.
23019196 - Cardiac sympathetic imaging with mibg in cirrhosis and portal hypertension: relation to...
19367146 - Reappraisal of the role of diuretics in heart failure.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-3
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  -     ISSN:  1558-2035     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aHeart Surgery Department, San Raffaele Hospital, Milan, Italy bCardiology Department, University of Foggia, San Giacomo Hospital, Monopoli, Bari, Italy cCardiology Department, University of Foggia, Foggia, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Atherosclerotic burden in coronary and peripheral arteries in patients with first clinical manifesta...
Next Document:  Multislice computed tomography in the diagnosis of coronary anomalies with superimposed coronary art...