No Structural Signposts: Afterload-Dependent Mitral Regurgitation

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Presentation transcript:

No Structural Signposts: Afterload-Dependent Mitral Regurgitation David Furfaro, MD, Karly Murphy, MD, Jordan Chaisson, MD, Jose Madrazo, MD, Sammy Zakaria, MD, MPH The American Journal of Medicine Volume 129, Issue 8, Pages 808-811 (August 2016) DOI: 10.1016/j.amjmed.2016.04.003 Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 1 The patient underwent transesophageal echocardiogram. (A) A 2-chamber view showed a structurally normal mitral valve at baseline with normal coaptation of leaflets. (B) The long-axis view provided the same findings. (C) A 2-chamber view with color Doppler demonstrated mild mitral regurgitation at baseline and no mitral valve prolapse or flail leaflets. (D) The same results were obtained on a long-axis view with color Doppler. The American Journal of Medicine 2016 129, 808-811DOI: (10.1016/j.amjmed.2016.04.003) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 2 Provocative testing during a transthoracic echocardiogram revealed mild to moderate mitral regurgitation at baseline (1A) and severe mitral regurgitation with infusion of 0.2 μg/kg/min of norepinephrine (2A). Right ventricular systolic pressure increased from 26 mm Hg at baseline (1B) to 88 mm Hg with norepinephrine infusion (2B). Systolic flow reversal developed in the pulmonary veins with norepinephrine infusion (1C and 2C). The American Journal of Medicine 2016 129, 808-811DOI: (10.1016/j.amjmed.2016.04.003) Copyright © 2016 Elsevier Inc. Terms and Conditions