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Acute Mitral Valve Regurgitation Presenting With Right Upper Lobe Opacification
John Wallis1, Daniel I Shpigel2, Dane O'Donnell3
1Department of Medicine, Division of Cardiology, Stony Brook University Hospital, Stony Brook, USA.
Cureus
|October 19, 2022
Summary
Severe mitral regurgitation can cause sudden respiratory failure, mimicking pneumonia. Prompt diagnosis via echocardiography is crucial for timely intervention and improved patient outcomes.
Area of Science:
- Cardiology
- Pulmonary Medicine
- Critical Care Medicine
Background:
- Mitral regurgitation (MR) can lead to focal pulmonary edema via a regurgitant jet mechanism.
- This mechanism selectively increases hydrostatic pressure in specific pulmonary veins, causing focal lung consolidation.
Observation:
- A 62-year-old female presented with acute hypoxic respiratory failure and cardiogenic shock.
- Initial presentation included severe hypoxia (23% oxygen saturation) and asymmetric lung opacities on chest radiographs, initially suspected to be infectious.
- Echocardiography revealed a ruptured papillary muscle leading to severe mitral regurgitation.
Findings:
- The patient's asymmetric lung findings, initially suggestive of pneumonia, were attributed to acute severe mitral regurgitation.
- Cardiogenic shock and respiratory failure resolved rapidly after emergency mitral valve replacement.
Implications:
- Acute severe mitral regurgitation can present as life-threatening respiratory failure and cardiogenic shock, often misdiagnosed as pneumonia.
- Early diagnosis using echocardiography is critical for appropriate management and can significantly reduce morbidity and mortality.
- Increased awareness of this clinical presentation is essential for healthcare providers to ensure timely and effective treatment.
Keywords:
acute cardiogenic pulmonary edemaacute mitral regurgitationacute mitral valve regurgitationcardiogenic shockmitral regurgitationmitral valve regurgitationmitral valve replacementnon-ischemic cardiac pathologiesopacification of hemithoraxpapillary muscle ruptureMore Related Videos
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