Can I read Acute Encephalopathy: An Atypical Presentation Of Flail Mitral Valve on EtoBox?

Acute Encephalopathy: An Atypical Presentation Of Flail Mitral Valve by Preeti Singhal; Shruti Rao; Everett Lai; David Daniels; Jonathan Michael Wong is a Medicine article available to read on EtoBox.

What is Acute Encephalopathy: An Atypical Presentation Of Flail Mitral Valve about?

Background: Dyspnea, weakness, and dizziness are among the varied presentations of severe primary mitral regurgitation (MR); encephalopathy is a rare presenting symptom of acute MR from flail mitral leaflet. Case: An 81YO man with atrial fibrillation (AF) on rivaroxaban presented with acute expressive aphasia. He was in AF, tachycardic, with a holosystolic murmur, and elevated NT-pro BNP. Urgent brain imaging showed no stroke. Additional evaluation revealed new dyspnea and orthopnea, a soft systolic murmur, and pulmonary edema on chest x-ray. TTE showed posterior mitral leaflet prolapse with moderatesevere eccentric MR and LVEF of 65%. Encephalopathic episodes recurred. ## Decision-making: The presentation was concerning for cerebral hypoperfusion due to cardiogenic shock (CS) from acute MR. Right heart catheterization confirmed CS and an IABP was placed. TEE showed P2 flail with associated severe MR. After multidisciplinary discussion, transcatheter edge-to-edge repair (TEER) was performed with residual trace MR (Fig. 1). He was weaned off IABP and discharged on medical heart failure therapy for a post-procedure LVEF of 35%. He remained asymptomatic at follow-up and with normalize

Who reads Acute Encephalopathy: An Atypical Presentation Of Flail Mitral Valve?

Author

Preeti Singhal; Shruti Rao; Everett Lai; David Daniels; Jonathan Michael Wong

Publisher

Elsevier BV

Published

2023

Language

EN

Field

Medicine (Health Sciences)