Advertisment Polium-B
Indian Journal of Critical Care Medicine
An open access publication of ISCCM™ 
 
Users online: 371 
     Home | Login 
  About Current Issue Archive Search Instructions Online Submission Subscribe Etcetera Contact  
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed292    
    Printed1    
    Emailed0    
    PDF Downloaded64    
    Comments [Add]    

Recommend this journal

 

 CASE REPORT
Year : 2018  |  Volume : 22  |  Issue : 11  |  Page : 806--808

Papillary muscle dysfunction due to coronary slow-flow phenomenon presenting with acute mitral regurgitation and unilateral pulmonary edema


Department of Critical Care Medicine, Narayana Multispecialty Hospital, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Jose Chacko
Department of Critical Care Medicine, Narayana Multispecialty Hospital, Bengaluru, Karnataka
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijccm.IJCCM_343_18

Rights and Permissions

Cardiogenic pulmonary edema usually presents with characteristic clinical features and bilateral infiltrates on the chest radiograph. Rarely, pulmonary edema may manifest unilaterally, leading to a mistaken diagnosis of a primary lung pathology. We present a 30-year-old man who developed acute coronary syndrome following an overdose of alprazolam. He developed breathlessness with unilateral infiltrates on the chest radiograph. Echocardiography revealed regional wall motion abnormalities related to underlying ischemia and acute mitral regurgitation with an eccentric jet. Besides, he had significant impairment of left ventricular systolic function. His coronary angiogram revealed a slow-flow phenomenon in the right coronary and left anterior descending artery territories. Ischemia-related dysfunction of the posterolateral papillary muscle probably led to a floppy posterior mitral leaflet and an eccentrically directed regurgitant jet, leading to unilateral pulmonary edema. He was commenced on dual antiplatelet therapy, heparin infusion, atorvastatin, frusemide, and ramipril, following which he showed gradual clinical improvement along with resolution of the radiological infiltrates. His left ventricular function improved, and the mitral valve function normalized on echocardiography within a week.






[FULL TEXT] [PDF]*


        
Print this article     Email this article

Online since 7th April '04
Published by Wolters Kluwer - Medknow