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Diagnóstico da rotura do músculo papilar no infarto agudo do miocárdio através do ecodopplercardiograma transesofágico / Papillary Muscle Rupture Assessment Due To Acute Myocardial Infarction by Transesophagecel Echocardiography
Baruzzi, Antonio Claudio do Amaral; Knobel, Elias; Cirenza, Claudio; Smith, Michael Roy; Ozawa, Elisabete; Gonçalves Júnior, Iran; Akamine, Nelson; Fernandes Júnior, Constantino José.
Afiliação
  • Baruzzi, Antonio Claudio do Amaral; s.af
  • Knobel, Elias; s.af
  • Cirenza, Claudio; s.af
  • Smith, Michael Roy; s.af
  • Ozawa, Elisabete; s.af
  • Gonçalves Júnior, Iran; s.af
  • Akamine, Nelson; s.af
  • Fernandes Júnior, Constantino José; s.af
Arq. bras. cardiol ; 63(1): 39-44, jul. 1994. ilus, tab
Artigo em Português | LILACS | ID: lil-155537
Biblioteca responsável: BR1.1
RESUMO
Three patients, two females, ages ranging from 62 to 78 years were studied, evolving with hypotension, acute pulmonary edema and cardiogenic shock. One had anterior myocardial infarction, and in two, infero-posterior. Due to severe hemodynamic instability and necessity of vasoactive drug therapy to maintain adequate arterial pressure, coronary angiography was performed in two, showing total occlusion of the circumflex artery and severe mitral regurgitation. In one case, angioplasty on the circumflex artery was successfully achieved. No hemodynamic improvement was observed, however. Doppler echocardiography depicted mild to moderate mitral regurgitation in the three cases. Transesophageal echo confirmed the clinical suspicion of papillary muscle rupture total rupture of antero-lateral papillary muscle in one patient, as well as total and partial rupture of the postero-medial papillary muscle in the other two patients. Two patients were submitted to mitral valve replacement, and the surgical findings confirmed the transesophageal echo conclusions. One of them died in the immediate pos-operative period, whereas the other was discharged from the hospital and is doing well. The third patient died before operation. Differential diagnosis of acute mitral regurgitation due to papillary muscle dysfunction or rupture was not possible by left ventriculography or by transthoracic echo. Transesophageal echo was the only exam to clearly confirm papillary muscle rupture, as should be done promptly after clinical suspicion of this severe condition arises
Assuntos
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Assunto principal: Músculos Papilares / Ruptura Cardíaca Pós-Infarto / Ecocardiografia Doppler / Ecocardiografia Transesofagiana Tipo de estudo: Estudo diagnóstico / Estudo de etiologia Limite: Feminino / Humanos / Masculino Idioma: Português Revista: Arq. bras. cardiol Assunto da revista: Cardiologia Ano de publicação: 1994 Tipo de documento: Artigo
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Assunto principal: Músculos Papilares / Ruptura Cardíaca Pós-Infarto / Ecocardiografia Doppler / Ecocardiografia Transesofagiana Tipo de estudo: Estudo diagnóstico / Estudo de etiologia Limite: Feminino / Humanos / Masculino Idioma: Português Revista: Arq. bras. cardiol Assunto da revista: Cardiologia Ano de publicação: 1994 Tipo de documento: Artigo
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