RESUMO
Resumen: La insuficiencia mitral aguda por rotura de músculo papilar, como complicación del infarto agudo de miocardio (IAM), ha disminuido su incidencia con las estrategias de reperfusión miocárdica coronaria. La actual pandemia (COVID-19) ha generado alerta en la comunidad cardiológica por el riesgo de consultas tardías en pacientes con síndrome coronario agudo, con las consecuencias derivadas de una reperfusión tardía. Presentamos el caso de una paciente con IAM que en la evolución padece esta complicación.
Summary: Acute mitral regurgitation from ruptured papillary muscle such, as complication of acute myocardial infarction, has decreased its incidence with myocardial coronary reperfusion strategies. The current pandemic (COVID-19) has generated an alert in the cardiology community due to the risk of late consultations in patients with acute coronary syndrome, with the consequences derived from a late reperfusion. We present the case of a patient with acute myocardial infarction who in evolution suffers this complication.
Sumário: Regurgitação mitral aguda do músculo papilar rompido, como complicação do infarto agudo do miocárdio, sua incidência diminuiu com estratégias de reperfusão miocárdica coronário. A pandemia atual (COVID-19) gerou um alerta na comunidade de cardiologia devido ao risco de consultas tardias em pacientes com síndrome coronariana aguda, com as consequências derivado de uma reperfusão tardia. Apresentamos o caso de uma paciente com infarto agudo do miocárdio que na evolução sofre essa complicação.
RESUMO
A 76-year-old man with a complaint of dyspnea was diagnosed with acute severe mitral regurgitation due to ruptured chordae tendineae. For improvement of pulmonary congestion, we introduced IMPELLA 5.0® and extra-corporeal membrane oxygenation before valve surgery. After two-days' IMPELLA 5.0® support, mitral valve replacement surgery with a bioprosthetic valve was performed and IMPELLA 5.0® was withdrawn. We report a successful case of a bridge to surgery using IMPELLA 5.0® with mitral valve regurgitation accompanied by acute left heart failure with severe respiratory failure.
RESUMO
A 62-year-old woman was admitted to a regional hospital for acute myocardial infarction. Emergency coronary angiography revealed occlusion of the first diagonal branch, and transesophageal echocardiography showed severe mitral regurgitation due to anterior papillary muscle rupture. She was transferred to our hospital in a state of cardiogenic shock despite the use of high-dose catecholamine and intra-aortic balloon pumping. We immediately performed mitral valve replacement. The patient's postoperative course was uneventful and she was ambulatory when transferred to another hospital on foot on postoperative day 19. Physicians should be aware that fatal anterior papillary muscle rupture may be caused by isolated occlusion of the diagonal branch.
RESUMO
The majority of patients who was presented as severe mitral regurgitation can be managed with medical treatment. However, some cases of severe and acute mitral regurgitation need to rapid surgical intervention like as primary angioplasty for acute myocardial infarction. In this case, a patient with acute and severe mitral regurgitation presented as accelerating shortness of breath and impending multi-organ perfusion failure was dramatically recovered by rapid echocardiographic diagnosis and emergency valve replacement operation.