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Acute mitral regurgitation as a cause of unilateral pulmonary edema

Publication |
2020

Abstract

Unilateral pulmonary edema accounts for 2% of cardiogenic pulmonary edemas. Etiology is variable, severe mitral regurgitation being the most common.

In the majority of cases, pulmonary edema occurs in the right upper lobe. Due to unusual presentation, the initiation of appropriate treatment tends to be delayed.

We present a case of a very dramatic and rare mechanical complication of a small myocardial infarction. The patient's condition was initially incorrectly described as pneumonia.

He was admitted due to severe respiratory insufficiency, his condition required mechanical ventilation, later V-V ECMO was initiated. Afterwards, echocardiography revealed acute severe mitral regurgitation with flail posterior leaflet and eccentric jet directed towards right pulmonary veins.

Selective coronarography revealed severe stenosis of the left circumflex artery and plain old balloon angioplasty was performed. Subsequently, surgical valve replacement took place.

The objective of this paper is to present an unusual case and its pathophysiology.