Title: Case Report: Acute Chordae Tendineae Rupture and Mitral Regurgitation in Pregnancy
Authors: Dr Sachin Ajit Kumar Adukia, Dr Arundhati Girish Diwan, Dr Chandrakant Chavan
DOI: https://dx.doi.org/10.18535/jmscr/v4i10.108
A 29 year old woman complained of breathlessness, chest pain and palpitations at 36 weeks of gestation. A pansystolic murmur alongwith bilateral basal crepitations were heard on auscultation. Echocardiography revealed a thickened anterior mitral leaflet with doming and a fixed posterior mitral leaflet. It also revealed chordae tendineae rupture. These findings were consistent with the diagnosis of acute heart failure due to ruptured chordae tendineae. An elective caesarean section was performed under general anaesthesia and a female child of 1.67kgs was born. The patient subsequently recovered and was discharged. Though acute heart failure in pregnancy may be life threatening, proper diagnosis and treatment in the ICU can assure a good outcome. KEYWORDS:- Acute LVF, mitral valve edema. 1. Caves PK, Paneth M. Acute MR in pregnancy due to ruptured chordae tendineae. Br Heart J 1972; 34: 541-544. 2. Nakash A, Arafa A, Vrapi F, Zaid R. An unusual case of peripartum ruptured mitral valve. Jr Obstetric Gynaecology 2009; 29:768-76. 3. SugikoOhishi, Hyase Nitta, Yukiko Chinen et al. Acute congestive heart failure due to ruptured mitral chordate tendineae in late pregnancy. J. Obstetric Gynaecology. Res 2013; 39(3):724-726. 4. Olivera DB, Dawkins KD, Kay PH, Paneth M. Chordal rupture. I: Aetiology and natural history. Br Heart J 1983; 50:312-317. 5. Castillo RA, Llado I, Adamsons K. Ruptured chordaltendineae complicating pregnancy. A case report. J. Reproductive medicine 1987; 32:137-39. 6. Hagway ZJ, Weissman A, Geva D, Snir E, Capsi A. Labor and delivery complicated by acute mitral regurgitation due to ruptured chordate tendineae. Am J. Perinatology 1995; 12:111-12 7. Raffery EB, Oakley CM, Goodwin JF. Acute subvalvular mitral incompetence. Lancet 1966; 360-365. 8. Gregori Junior, Francisco et al. Surgical repair of chordae tendineae rupture after degenerative valvular regurgitation using standardized bovine pericardium. Rev Bras Cir Cardiovasc [online]. 2013, vol.28, n.1 [cited 2013-07-05], pp. 36-46 . Available from:<http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102- 7638201300-0100007&lng=en&nrm=iso>.ISSN0102-7638. http://dx.doi.org/10.5935/1678-9741.20130007Abstract
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