Mitral regurgitation
Diagnosis
- Most common cause is papillary / chordae rupture after MI[1]
- Day 2-7
- MI, Endocarditis, Trauma
- Severe dyspnea, tachycardia, pulmonary edema
- Suspect if new-onset pulm edema + normal heart size
- Cardiogenic shock may develop
- S4, apical systolic murmur
Treatment
- Decrease pulmonary edema
- O2, nitrates, diuretics
- Increase forward flow
- Decrease afterload
- Consider nitroprusside in normotensive pts
- Dobutamine
- Consult Cards/CT Surg
- Intra-aortic balloon pump, emergency surgery
See Also
Source
- Tintinalli
- Kosowsky JM: Infective Endocarditis and Valvular Heart Disease, in Marx JA, Hockberger RS, Walls RM, et al (eds): Emergency Medicine: Concepts and Clinical Practice, ed. 7. St. Louis, Mosby, Inc., 2010, (Ch) 81: p.1072-1074.
- ↑ Kosowsky JM: Infective Endocarditis and Valvular Heart Disease, in Marx JA, Hockberger RS, Walls RM, et al (eds): Emergency Medicine: Concepts and Clinical Practice, ed. 7. St. Louis, Mosby, Inc., 2010, (Ch) 81: p.1072-1074.