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.
Favaretto
Enrico
E
Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Tarantini
Giuseppe
G
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