Cardiogenic shock as a complication of acute mitral valve regurgitation following posteromedial papillary muscle infarction in the absence of coronary artery disease

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Abstract

A 48 year old man was transferred to our department with cardiogenic shock, pyrexia, a high white cell count and significant serum troponin T level. Clinical evaluation revealed severe mitral regurgitation secondary to a flail of both mitral valve leaflets. An emergency cardiac catheterisation did not reveal any significant coronary artery disease. Left ventricular angiogram and echocardiography demonstrated a good left ventricular function and massive mitral regurgitation. Blood cultures were negative for aerobics, anaerobics and fungi. The patient underwent emergency mitral valve replacement with a mechanical valve. Intraoperatively, the posteromedial papillary muscle was found to be ruptured. Histology of the papillary muscle revealed myocardial necrosis with no signs of infection. Cultures obtained from a mitral valve specimen were negative. The patient's recovery was uneventful and he was discharged on the 6th postoperative day. © 2008 Bizzarri et al; licensee BioMed Central Ltd.

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Bizzarri, F., Mattia, C., Ricci, M., Coluzzi, F., Petrozza, V., Frati, G., … Muzzi, L. (2008). Cardiogenic shock as a complication of acute mitral valve regurgitation following posteromedial papillary muscle infarction in the absence of coronary artery disease. Journal of Cardiothoracic Surgery, 3(1). https://doi.org/10.1186/1749-8090-3-61

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