title: Second diastolic pulmonary venous flow and isolated late diastolic mitral valve regurgitation in first-degree atrioventricular block.
abstract: The authors report the case of a 77-year-old male patient with sinus rhythm and a first-degree atrioventricular (AV) block who was referred for echocardiographic follow-up 18 years after aortic valve replacement. Left ventricular systolic function as well as the function of the aortic prosthesis was normal. Systolic mitral regurgitation (MR) was virtually absent, but isolated late diastolic MR was detected by colour Doppler imaging. Coincidental to the occurrence of diastolic MR, a second late diastolic forward flow in the pulmonary veins was observed. Therefore, during the prolonged left atrial relaxation caused by first-degree AV block, the left atrial pressure drops below the pressure in both adjacent chambers in late diastole, resulting in both late diastolic MR and a second diastolic pulmonary venous forward flow.
authors.affiliation: University Hospital Basel, Basel, Switzerland. kardiologie@mac.com
authors.forename: Gregor
authors.initials: G
authors.lastname: Leibundgut
authors.forename: Alain M
authors.initials: AM
authors.lastname: Bernheim
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D054537:Atrioventricular Block / Q000150:complications* / Q000000981:diagnostic imaging; D003971:Diastole / Q000502:physiology; D004452:Echocardiography / Q000379:methods*; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000503:physiopathology; D012039:Regional Blood Flow