[Acute mitral incompetence of ischemic origin (author's transl)].
Clinical findings and results of treatment in 17 patients with acute mitral incompetence are described. The lesions were secondary to a recent myocardial necrosis causing severe cardiac failure (shock, or acute left ventricular failure), and the presence of mitral incompetence was confirmed by right catherization (15 cases) and/or left ventricular angiography (13 cases). The anatomical lesions are described in 14 cases: rupture of the posterior mitral papillary muscle in 7 cases, and acute dysfunction of the muscle in 7 other cases. Eight patients were treated by an intra-aortic balloon to assist circulation, and 14 were given vasodilators (phentolamine, trinitrin) associated in 5 cases with positive inotropic drugs. Surgical treatment was given (mitral valve replacement) in 7 cases. The respective effects of vasodilators and circulatory assistance are discussed, as well as the indications for, and results of urgent surgical treatment (6 successes in 7 operations).
D000208:Acute Disease; D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications*; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D011379:Prognosis; D014665:Vasodilator Agents / Q000627:therapeutic use
D014665:Vasodilator Agents
L'insuffisance mitrale aiguë d'origine ischémique.