Acute and Critical Care

Cardiology/Pulmonary
Massive Hemoptysis due to Acute Mitral Regurgitation with Sporadic Primary Mitral Valve Prolapse: Won Young Chae, Sun Jin Park, Chi Woo Song, Byoung Hoon Lee, Sang Hoon Kim, Jae Hyung Lee; Korean J Crit Care Med. 2015;30(3):202-206. Published online August 31, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.3.202

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The most common cardiac cause of massive hemoptysis is mitral stenosis. Mitral regurgitation is rarely complicated by massive hemoptysis. A 48-year-old man with no significant medical history was admitted to our hospital with hemoptysis and production of 500 mL of blood within 24 hours. A pan-systolic murmur was found on chest examination. A chest computed tomography showed airspace consolidation in the right upper and middle lobes, with faint bilateral ground glass opacity. Echocardiography revealed mitral valve prolapse and grade IV mitral regurgitation. The patient was diagnosed with sporadic primary mitral valve prolapse. After mitral valve repair surgery, the patient recovered fully.

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Surgically‐treated hemoptysis and alveolar hemorrhaging resulting from severe mitral regurgitation: A case report
Daisuke Yamaguchi, Toshiya Tokui, Takahiro Narukawa, Masahiko Murakami, Tomotake Sekoguchi, Ryosai Inoue, Koji Hirano, Yasumi Maze, Hisato Ito
Clinical Case Reports.2023;[Epub] CrossRef
Acute mitral valve regurgitation causing severe alveolar hemorrhage
Ayaka Sakamoto, Yuki Enomoto, Hiroaki Watabe, Yasuaki Koyama, Yukei Matsumoto, Nobutake Shimojo, Aiki Marushima, Satoru Kawano, Yoshiaki Inoue
Acute Medicine & Surgery.2020;[Epub] CrossRef
Man With Sudden Dyspnea and Hemoptysis
Naoki Kawakami, Rina Kato, Chushu Liu, Kazuhiko Takahashi, Yoko Wakai, Kazuhito Saito
Annals of Emergency Medicine.2020; 75(5): 668. CrossRef

Cardiology
Isolated Chylopericardium after Mitral Valve Replacement: the First Description of Adult Heart Disease in Korea: Su Wan Kim, Seogjae Lee; Korean J Crit Care Med. 2014;29(2):123-125. Published online May 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.2.123

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Abstract PDF: Isolated chylopericardium as a complication of cardiac surgery is very rare. Two cases of chylopericardium have been previously reported in Korea; both patients suffered from chylopericardium after a corrective cardiac surgery for a congenital heart disease such as atrial or ventricular septal defect. We report a case of chylopericardium in a 55-year-old mitral valve replacement patient. The reason for chylopericardium was unclear, but it might have been related with the damaged lymph nodes and blunt dissection of the thymus. While most chylopericardium cases require surgical intervention, we managed this chylopericardium case with a low-fat diet for 3 days.

A Case of Fatal Mechanical Mitral Valve Leaflet Fracture Embolization: A Case Report: Won Yik Lee, Jong Myeon Hong, Jang Whan Bae; Korean J Crit Care Med. 2011;26(2):101-104.; DOI: https://doi.org/10.4266/kjccm.2011.26.2.101

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The fracture embolization of a mechanical valve is a very rare but potentially fatal event that can cause acute severe valve regurgitation and subsequent decompensated heart failure. Generally, the mechanical valve is durable and semi-permanent. If this is not the case, bacterial endocarditis can occur. However, leaflet fracture embolizations related to mechanical failure may occur in the specific mechanical valve brands associated with the subjects own structural fragilities. In this case, we dealt with a case of fatal Edward-Duromedics mechanical mitral valve leaflet fracture embolization that had been implanted 20 years ago. The patient presented with severe acute heart failure and shock. Severe transvalvular mitral regurgitation and only one valve leaflet was observed in echocardiography. Although the emergency mitral valve replacement was performed under the diagnosis with valve leaflet fracture embolization, the patient was not resuscitated from systolic pump failure and died.

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An unusual cause of acute mitral regurgitation in TTK Chitra heart valve prosthesis
Muthukumar Sundaram, Aayush Poddar, Ancy Robinson, Soundaravalli Balakrishnan, Muralidharan Srinivasan, Chandrasekar Padmanabhan
Indian Journal of Thoracic and Cardiovascular Surgery.2021; 37(5): 546. CrossRef

Use of Femorofemoral Bypass for Life Saving before the Emergency Replacement of Thrombotic Prosthetic Mitral Valve: Il Woo Shin, Hyoung Chan Cho, Wan Soo Choi, Woo Chang Yang, Hyun Keun Lee, Young Kyun Chung; Korean J Crit Care Med. 2000;15(1):47-51.

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Abstract PDF: Mechanical valves have generally good hemodynamic function and indefinite durability, but they have a higher thromboembolic potential and thus a requirement for permanent anticoagulation, because thrombotic occlusion is a potentially fatal complication of heart valve replacement surgery. We had experienced mitral valve replacement because of thrombosis around the replaced prosthetic valve. The patient's mechanical prosthetic valve was acutely obstructed by thrombosis, and it was a life threatening condition. We performed partial bypass through femorofemoral bypass for life saving. Femorofemoral bypass improved oxygenation and cardiovascular stability, and mitral valve replacement was successfully performed without complication.

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