[Mitral insufficiency related to a spasm of the left anterior descending artery. A case report].

Abstract

We report the case of a female patient of 76 years old admitted to our hospital for a pre-operative assessment of a symptomatic mitral regurgitation (MR) whose transthoracic echocardiography revealed only a trivial regurgitation. The occurrence during hospital stay of an acute pulmonary edema contemporary to the occurrence of a huge MR permitted to suspect the diagnosis of a paroxystic ischemic MR. Angiographic and hemodynamic evaluation revealed only a non-significant atheromateous plaque located in the distal LAD. The infusion of Methylergometrine triggered a severe spasm at the site of that plaque, associated with a huge MR visualized by TTE with restricted movements of both leaflets, responsible for an acute pulmonary edema occurring on the table of the catheterization laboratory. Recovery was quickly obtained after intravenous injection of Nitroglycerin, which removed the spasm and valvular regurgitation. The diagnosis of paroxystic ischemic mitral regurgitation was confirmed and a treatment based on high dosage of calcium-blocker was decided. After a follow-up of more than one year, the patient remains asymptomatic and the regurgitation has never occurred.

• Authors: F Thuny, P Dieuzaide, J F Avierinos, F Collart, J Quilici, F Franceschi, P Sbragia, G Habib, J L Bonnet, T Mesana
• Journal: Archives des maladies du coeur et des vaisseaux (Arch Mal Coeur Vaiss) Vol. 96 Issue 1 Pg. 62-5 (Jan 2003) ISSN: 0003-9683 [Print] France
• Vernacular Title: Insuffisance mitrale due à un spasme de l'IVA. A propos d'un cas.
• PMID: 12613153 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Calcium Channel Blockers
• Vasodilator Agents
• Nitroglycerin

Topics

• Aged
• Arteriosclerosis (complications)
• Calcium Channel Blockers (therapeutic use)
• Cardiac Catheterization
• Coronary Vasospasm (complications, drug therapy)
• Echocardiography
• Female
• Hemodynamics
• Humans
• Magnetic Resonance Imaging
• Mitral Valve Insufficiency
• Myocardial Ischemia (etiology)
• Nitroglycerin (therapeutic use)
• Pulmonary Edema (etiology)
• Vasodilator Agents (therapeutic use)