scholarly journals 759 Mitral regurgitation assessment before revascularization after myocardial infarction — comparison of 3D real time vs 2D transthoracic echocardiography

2005 ◽  
Vol 6 ◽  
pp. S116-S116
Keyword(s):  
Myocardial Infarction ◽  
Mitral Regurgitation ◽  
Real Time ◽  
Transthoracic Echocardiography

scholarly journals P1481 Embolic infarct in a known coronary artery disease patient

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A H Ali ◽  
U Alnuaimi ◽  
S I Lacau ◽  
C Badiu ◽  
A C Popescu
Keyword(s):  
Myocardial Infarction ◽  
Mitral Regurgitation ◽  
Transthoracic Echocardiography ◽  
Disease Patient ◽  
Mitral Annulus ◽  
Left Ventricular ◽  
Inferior Wall ◽  
Mitral Leaflet ◽  
St Segment ◽  
Posterior Mitral Leaflet

Abstract A 60 y/o diabetic and hypertensive lady with previous anterior infarction treated by primary PCI with stenting of the proximal LAD (2011) and CABG for stent thrombosis, presented for chest pain. Admission ECG showed ST segment elevation in II, III aVF, ST segment depression in V1-V2 (A). Urgent coronary angiography was performed. It showed non-significant lesions on RCA and LCX, occlusion of the proximal LAD stent, patent LIMA to LAD and first diagonal with non-significant stenosis of the distal anastomosis (B). Transthoracic echocardiography (C) showed calcific mass involving the mitral annulus and posterior mitral leaflet, moderate mitral regurgitation, hipokinesia of the basal segment of the inferior wall with preserved LV ejection fraction. Transesophageal echocardiography (D) confirmed the calcified mass involving the mitral annulus and the posterior mitral leaflet. There was no significant mitral stenosis, and mitral regurgitation was moderate. Thoracic CT showed massive mitral calcification and a possible thrombus attached to it. (E) Myocardial infarction was confirmed by troponin rise and fall. The patient was discharged on dual antiplatelet therapy, ACE-I, betablocker and statin. At one month follow-up transthoracic echocardiography the central area of the mitral mass became hypoechogenic, and a bilobated hypermobile structure was seen attached to the ventricular side of the mass (F). Blood cultures were negative and there was no inflammatory syndrome. Cardiac magnetic resonance (H) confirmed myocardial infarction and showed massive calcification of the posterior mitral annulus. TEE performed after another month showed a very long hypermobile structure attached to the mitral annulus calcification, which was entering the left ventricular outflow tract reaching the plane of the aortic valve (G). The patient underwent surgical mitral valve replacement and redo CABG and the mass was excised. The pathologic aspect of the excised material was cazeous and friable (I). The initial presentation was presumably an embolic infarct with cazeous material. Abstract P1481 Figure.

scholarly journals Diagnostic Pitfalls in Papillary Muscle Rupture-Associated Acute Mitral Regurgitation after Acute Myocardial Infarction

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Akiko Kameyama ◽  
Hiroshi Imamura ◽  
Hiroshi Kamijo ◽  
Kanako Takeshige ◽  
Katsunori Mochizuki ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Mitral Regurgitation ◽  
Papillary Muscle ◽  
Transthoracic Echocardiography ◽  
Heart Surgery ◽  
Systolic Murmur ◽  
Papillary Muscle Rupture ◽  
Muscle Rupture ◽  
Acute Mitral Regurgitation

Papillary muscle rupture (PMR) is a rare and fatal complication of acute myocardial infarction (AMI). We report a case of acute mitral regurgitation (MR) due to PMR with pulmonary edema and cardiogenic shock following AMI with small myocardial necrosis. An 88-year-old woman was brought to our emergency department in acute respiratory distress, shock, and coma. She had no systolic murmur, and transthoracic echocardiography was inconclusive. Coronary angiography showed obstruction of the posterior descending branch of the right coronary artery. Although the infarction was small, the hemodynamics did not improve. Transesophageal echocardiography established papillary muscle rupture with severe mitral regurgitation 5 days after admission. Thereafter, the patient and her family did not consent to heart surgery, and she eventually died of progressive heart failure. Physicians should be aware of papillary muscle rupture with acute mitral regurgitation following AMI in patients with unstable hemodynamics, no systolic murmur, and no abnormalities revealed on transthoracic echocardiography.

Abstract 3385: Role Of Regional Geometric Dyssynchrony By Real-time Three-dimensional Echocardiography As A Determinant Of Functional Mitral Regurgitation In Patients With Acute Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Chung-Lieh Hung ◽  
Anil Verma ◽  
Rahman Shah ◽  
Charles Jia-Yin Hou ◽  
Hung-I Yeh ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Mitral Regurgitation ◽  
Real Time ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Acute Mi ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

Background: Functional mitral regurgitation (FMR) after myocardial infarction (MI) is associated with left ventricular (LV) dys-synchrony and increased mortality. However, determinants of FMR severity after acute MI are poorly defined. Our aim was (1) to test whether real-time Three-Dimensional echocardiography (RT-3DE) can provide insights into the mechanism of LV dys-synchrony on MR severity after MI (2) to investigate role of selective regional dys-synchrony index (DI) in prediction of FMR. Method: RT-3DE and Doppler echo was performed on 64 consecutive patients (mean age 62.2 ± 12.5 yrs) following acute MI without cardiogenic shock and with narrow QRS complex (< 120 ms). MR Severity was assessed by vena contracta, and MR jet area/LA area. Dyssynchrony index (DI) was derived from the dispersion of time to minimum regional volume for all 16 LV segments. Pearson’s correlation and multiple linear regression analysis were used to identify the relationship between FMR and DI. Different models of LV dys-synchrony including global index and selective ring-defined (basal, middle and apical ring) regional index were all analyzed and compared. Results: The mean LVEF was 49.6 ± 11.9% and LV end-diastolic volume (EDV) was 93.1 ± 23.8ml. All regional and global DIs were significantly correlated with FMR even after adjusting for age, LVEF and EDV (table 1 ), with mid-wall DI being most strongly associated with MR severity. Conclusion: RT-3DE determined mid-wall DI following MI is strongly associated with FMR. Our results suggest that selective geometric ring-defined DI has better FMR severity prediction and may provide specific approaches to the treatment of FMR complicating MI.

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