Systolic anterior movement of mitral valve during acute apical myocardial infarction: An unusual mechanism of acute mitral regurgitation.
We describe a singular case of a 75-year-old woman affected by an anterior acute myocardial infarction in the subset of a very recent orthopaedic surgery. She had had severe mitral regurgitation on coronary angiography. A thorough cardiac echocardiographic examination revealed the particular mechanism of mitral incompetence, consisting of a dynamic anterior mitral leaflet displacement caused by a sustained compensatory left ventricle hypercontractility and favored by postsurgical moderate anemia and mild hypertensive hypertrophy. The use of beta-blockers and the avoidance of pure vasodilators permitted complete reversal of such mechanisms during the clinical course.
Di Chiara
A
A
Coronary Care Unit, Cardiology Department, Azienda Ospedaliera S. Maria della Misericordia, Udine, Italy. antdich@tin.it
Plewka
M
M
Fioretti
P M
PM
D000208:Acute Disease; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000075202:Contraindications; D017023:Coronary Angiography; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000517:prevention & control; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012720:Severity of Illness Index; D013599:Systole; D014665:Vasodilator Agents
D000319:Adrenergic beta-Antagonists; D014665:Vasodilator Agents