Heart Murmurs – ABC CARDIOL

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Anatomopathological Correlation

Case 4 – A 59-Year-Old Woman with Rheumatic Mitral Valve Disease (Severe Stenosis and Regurgitation), Severe Dyspnea, Shock and Pulmonary Condensation

Desiderio Favarato et al. Vera Demarchi Aiello

Clinical aspects

This is about a 59-year-old woman with double mitral lesions with pulmonary hypertension who, while awaiting surgery, had arterial hypotension, respiratory failure with hypotransparency in the right lung field. It evolved without improvement with vasoactive drugs, orotracheal intubation and antibiotic therapy, and she passed away in electrical activity without pulse.

The etiology of this patient’s valve disease should be attributed to rheumatic fever, although there is no description of an acute outbreak of that disease in the patient’s medical history. That is not unusual in a rheumatic disease scenario once using echocardiogram raises its frequency from 5 to 10 times when compared to a clinical diagnosis.^–

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Clinicoradiological Session

Case 4/2018 – Important Mitral Valve Regurgitation Caused by Hammock Mitral Valve in 8 Year-Old Girl

Edmar Atik et al. Alessandra Costa Barreto Maria Angélica Binotto Renata de Sá Cassar

Clinical data

Heart murmur was auscultated during routine examination at 6 years of age, with complaints of tachycardia and chest pain at that time. A diagnosis of mitral regurgitation caused by hammock mitral valve was performed and enalapril 2.5 mg/day (0.1 mg/kg) was started. She reported being asymptomatic, capable of performing physical activity.

Physical examination: good overall health status, eupneic, acyanotic, normal pulses in the four limbs. Weight: 25 kg; height: 130 cm; right upper limb blood pressure: 90 x 60 mmHg; Heart Rate (HR): 96 bpm; Oxygen Saturation (O₂Sat): 97%.

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Clinicoradiological Session

Case 6 / 2014 – Five-year Old Child with Scimitar Syndrome and Pulmonary Sequestration of Right Lower Lobe

Edmar Atik

Complementary tests

Electrocardiogram: Showed sinus rhythm and RS morphology in right precordial and rs in V6 compatible with right ventricular overload. Ventricular repolarization was normal. AP: +20º, AQRS: +250º, AT: +30º.

Chest radiography: Shows hypoplasia of right lung with increased cardiac area positioned to the right and increased pulmonary vascular markings. There were signs of vascular imaging on the right side of the retrocardiac image with an outlining that resembled a scimitar ().

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Case 4 – A 59-Year-Old Woman with Rheumatic Mitral Valve Disease (Severe Stenosis and Regurgitation), Severe Dyspnea, Shock and Pulmonary Condensation

Clinical aspects

Case 4/2018 – Important Mitral Valve Regurgitation Caused by Hammock Mitral Valve in 8 Year-Old Girl

Clinical data

Case 6 / 2014 – Five-year Old Child with Scimitar Syndrome and Pulmonary Sequestration of Right Lower Lobe

Complementary tests

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Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)