Clinical images. Pulmonary edema without an obvious cause: handgrip-induced large dynamic changes in ischemic mitral regurgitation in the cath lab.
We report a case of pulmonary edema experienced in a patient with severe left ventricular dysfunction without an obvious cause. Thus, we tested the hypothesis of a dynamic increase in the severity of (ischemic) mitral regurgitation. Right- and left-heart cardiac catheterization was performed before and after 2 minutes of maximal handgrip. We observed an increase in the patient's left ventricular systolic and end-diastolic pressures, his pulmonary and wedge capillary pressures, his heart rate and severe mitral regurgitation.
Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Enrico
E
Favaretto
Giuseppe
G
Tarantini
D000208:Acute Disease; D006328:Cardiac Catheterization; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011654:Pulmonary Edema / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D011669:Pulmonary Wedge Pressure; D011859:Radiography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D017725:Ventricular Pressure