The enigma of occult mitral regurgitation in a patient with cardiogenic shock.
In patients with mitral regurgitation (MR), there is a high pressure gradient between the left ventricle (LV) and left atrium that Doppler echocardiography can easily detect. We present a case where transthoracic echocardiography (TTE) failed to provide an accurate evaluation of a patient who presented in cardiogenic shock. A transesophageal echocardiogram diagnosed MR because of a flail leaflet caused by a ruptured papillary muscle in the setting of normal ventricular function.
Shah
Alan
A
Department of Medicine, New York University School of Medicine, New York, New York, USA.
Kronzon
Itzhak
I
D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000503:physiopathology; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology; D018618:Echocardiography, Doppler, Color; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis* / Q000503:physiopathology*; D012770:Shock, Cardiogenic / Q000175:diagnosis* / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology