Massive Hemoptysis in the Setting of Acute Mitral Regurgitation

Hemoptysis and Unilateral Pulmonary Infiltrates due to Severe Acute Mitral Regurgitation from Papillary Muscle Rupture

“…Surprisingly, the CXR and CTA chest findings (Figures 1 – 3 ) were consistent with numerous reports of AMR [ 3 – 11 ]. Initial cardiac evaluation with TTE showed structurally normal mitral valve with moderate mitral regurgitation.…”

“…Patients with AMR usually present with acute onset of shortness of breath and hypotension. Atypical presentations of AMR have been associated with unilateral lobar consolidation and alveolar hemorrhage [ 1 , 3 , 4 , 11 ]. Consistent with the previous literature, our case shows a symptom constellation of sudden dyspnea, hemoptysis, and right-sided infiltration.…”

“…Consistent with the previous literature, our case shows a symptom constellation of sudden dyspnea, hemoptysis, and right-sided infiltration. While a cardiac etiology for hemoptysis is uncommon, an explanation of this symptom may come from the sudden increased pressure from the MR jet into the left atrium and subsequently the pulmonary venous system [ 11 ]. Evaluation of AMR with TEE showed an increased elevation pressure gradient directed at the orifice of the right pulmonary venous system compared to the left [ 5 ].…”

“…Evaluation of AMR with TEE showed an increased elevation pressure gradient directed at the orifice of the right pulmonary venous system compared to the left [ 5 ]. This sudden increase in right-sided pulmonary venous pressure can explain the process formation of right-sided pulmonary edema and alveolar hemorrhage [ 3 , 4 , 6 , 11 ].…”