Acute congestive heart failure due to ruptured mitral chordae tendineae in late pregnancy

S Ohishi, H Nitta, Y Chinen, T Kinjo… - Journal of Obstetrics …, 2013 - Wiley Online Library
S Ohishi, H Nitta, Y Chinen, T Kinjo, H Masamoto, K Sakumoto, T Maeda, Y Kuniyoshi
Journal of Obstetrics and Gynaecology Research, 2013Wiley Online Library
A 31‐year‐old woman complained of dyspnea and orthopnea at 38 weeks of gestation. A
grade 3/6 pansystolic murmur was heard, and echocardiography revealed severe mitral
regurgitation with a hyperechoic obstacle on the posterior mitral valve leaflet, consistent with
a diagnosis of acute heart failure due to a ruptured chordae tendineae or an infectious
endocarditis. An emergency cesarean section was performed under general anesthesia. A
male infant was born weighing 2928 g with A pgar scores of 7 and 8 at 1 and 5 min …
Abstract
A 31‐year‐old woman complained of dyspnea and orthopnea at 38 weeks of gestation. A grade 3/6 pansystolic murmur was heard, and echocardiography revealed severe mitral regurgitation with a hyperechoic obstacle on the posterior mitral valve leaflet, consistent with a diagnosis of acute heart failure due to a ruptured chordae tendineae or an infectious endocarditis. An emergency cesarean section was performed under general anesthesia. A male infant was born weighing 2928 g with Apgar scores of 7 and 8 at 1 and 5 min, respectively. The patient was managed in the intensive care unit and underwent open‐heart surgery for mitral valve repair on postpartum day 3. The two chordal tendineae appeared torn and frail, and a mitral annuloplasty was performed. No finding of infectious endocarditis was observed. Because it is a dramatic and life‐threatening clinical situation, proper diagnosis and treatment in the intensive care unit assure a good outcome for both mother and fetus.
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