Document Detail

Reversible severe ischemic mitral regurgitation and cardiogenic shock as a complication of percutaneous coronary intervention.
MedLine Citation:
PMID:  15687537     Owner:  NLM     Status:  MEDLINE    
We describe a case of severe ischemic mitral regurgitation (MR) causing reversible cardiogenic shock as a complication of percutaneous coronary intervention (PCI) of the circumflex due to no-reflow. Baseline echocardiography before PCI showed only mild MR. After the occurrence of no-reflow post stenting, patient developed acute hypotension, hypoxia, pulmonary edema, increase in pulmonary mean wedge pressure to 42 mmHg with very high V-wave during pulmonary wedge tracing and cardiogenic shock requiring intra-aortic balloon pump (IABP) insertion. Urgent echocardiography revealed severe MR. With the establishment of normal flow in the circumflex artery after IABP insertion and intracoronary adenosine injections, severe MR, hypoxia and all hemodynamic instability resolved. We present this case as a first documented complication of PCI causing severe reversible ischemic MR leading to cardiogenic shock and a review of the literature. We conclude that in all patients with sudden unexplained hemodynamic deterioration during PCI, an urgent echocardiogram is indicated to recognize possible acute ischemic MR.
Mohammad-Reza Movahed; Harry Balian; Pardise Moraghebi
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  17     ISSN:  1042-3931     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-02-02     Completed Date:  2006-04-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  104-7     Citation Subset:  IM    
Division of Cardiology, University of California, Irvine Medical Center, 101 The City Drive, Bldg. 53, Room 100, Orange, CA 92868, USA.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Coronary Angiography
Mitral Valve Insufficiency / etiology*,  physiopathology,  ultrasonography
Myocardial Ischemia / therapy*
Pulmonary Wedge Pressure
Severity of Illness Index
Shock, Cardiogenic / etiology*,  physiopathology,  ultrasonography

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