title: Red flag in the emergency department: fracture and primary failure of a prosthetic valve.
abstract: This case report concerns a patient with fracture and primary dysfunction of a prosthetic valve. A 40-year-old man presented to the Emergency Department with a chief complaint of breakthrough pleuritic back pain and shortness of breath. Past surgical history was significant only for an aortic valve replacement and mitral valve replacement performed 16 years prior. The transthoracic echocardiography raised suspicion of prosthesis malposition. The patient was taken to the operating room by cardiothoracic surgeons for valve replacement. Operative findings revealed that a prosthetic valve leaflet in the mitral position had broken off. Primary prosthetic valve failure should not be overlooked in the differential diagnosis of patients with valve replacement and a rapidly deteriorating clinical course. Emergency echocardiography is a guide to convenient diagnosis and management. Early surgical consultation and early reparative surgery might prevent unnecessary morbidity and mortality.
authors.affiliation: Department of Emergency Medicine, Bayindir Medical Center, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ozsarac
authors.forename: Ozgur
authors.initials: O
authors.lastname: Karcioglu
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Ayrik
authors.forename: Seyran
authors.initials: S
authors.lastname: Bozkurt
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Turkcuer
authors.forename: Serhat
authors.initials: S
authors.lastname: Gumrukcu
mesh_terms: D000328:Adult; D001021:Aortic Valve; D001416:Back Pain / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D017548:Echocardiography, Transesophageal; D004635:Emergency Medicine / Q000379:methods; D017809:Fatal Outcome; D006350:Heart Valve Prosthesis; D006801:Humans; D007022:Hypotension / Q000209:etiology; D008297:Male; D008943:Mitral Valve; D011475:Prosthesis Failure