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Acute congestive heart failure due to ruptured mitral chordae tendineae in late pregnancy
Author(s) -
Ohishi Sugiko,
Nitta Hayase,
Chinen Yukiko,
Kinjo Tadatsugu,
Masamoto Hitoshi,
Sakumoto Kaoru,
Maeda Tatsuya,
Kuniyoshi Yukio,
Aoki Yoichi
Publication year - 2013
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2012.02014.x
Subject(s) - medicine , chordae tendineae , mitral regurgitation , heart failure , cardiology , intensive care unit , mitral valve , heart murmur , endocarditis , mitral valve replacement , mitral valve regurgitation , surgery
A 31‐year‐old woman complained of dyspnea and orthopnea at 38 weeks of gestation. A grade 3/6 pansystolic murmur was heard, and echocardiography revealed severe mitral regurgitation with a hyperechoic obstacle on the posterior mitral valve leaflet, consistent with a diagnosis of acute heart failure due to a ruptured chordae tendineae or an infectious endocarditis. An emergency cesarean section was performed under general anesthesia. A male infant was born weighing 2928 g with A pgar scores of 7 and 8 at 1 and 5 min, respectively. The patient was managed in the intensive care unit and underwent open‐heart surgery for mitral valve repair on postpartum day 3. The two chordal tendineae appeared torn and frail, and a mitral annuloplasty was performed. No finding of infectious endocarditis was observed. Because it is a dramatic and life‐threatening clinical situation, proper diagnosis and treatment in the intensive care unit assure a good outcome for both mother and fetus.