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Acute Heart Failure In Settng Of Chest Pain And Fever by Jarmanjeet Singh; Bhavdeep Singh; Jasninder Singh Dhaliwal; Ashis Mukherjee; Joanna Chikwe; Issa G. Alesh is a Medicine article available to read on EtoBox.
What is Acute Heart Failure In Settng Of Chest Pain And Fever about?
Background: Acute mitral regurgitation (MR) can be ischemic or non-ischemic and often a cardiac emergency. We present a case where acute MR is likely a product of multiple factors in play. Case: A 74-year-old female with a history of breast cancer s/p radiation came with dyspnea, chest pain and fever. She had leukocytosis (19K/uL), elevated troponin (13ug/mL), high-sensitivity C-reactive protein (hsCRP) of 19 mg/dL, and was on BiPAP. TTE showed 55% EF and moderate MR. Coronary angiogram revealed subtotal occlusion of small first diagonal (D1) and IABP placed for shock. TEE showed severe MR with moderate anterior mitral valve leaflet prolapse (MVP) and inferolateral hypokinesis. During surgery, she was found to have chordae tendinea rupture (CTR). She underwent mitral annuloplasty, reimplantation of papillary muscle and chordae reconstruction with Gortex neochordae. (Figure ) Decision-making: Common causes of CTR include MVP, myxomatous degeneration, endocarditis and rheumatic heart disease. Severe MVP increases CTR risk but our patient didnʼt have any history of MVP. Fever and high hsCRP raised suspicion of myocarditis. Ischemia from D1 occlusion along with myocarditis can explain
Who reads Acute Heart Failure In Settng Of Chest Pain And Fever?
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- Author
- Jarmanjeet Singh; Bhavdeep Singh; Jasninder Singh Dhaliwal; Ashis Mukherjee; Joanna Chikwe; Issa G. Alesh
- Publisher
- Elsevier BV
- Published
- 2023
- Language
- EN
- Field
- Medicine (Health Sciences)