A Survival Case of Acute Mitral Regurgitation and Cardiogenic Shock Caused by Subtotal Occlusion of the First Diagonal Branch.
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- Takahashi Tohru
- Divisions of Cardiology, International Medical Center of Japan
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- Kohno Koji
- Cardiovascular Surgery, International Medical Center of Japan
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- Kashida Mitsuo
- Divisions of Cardiology, International Medical Center of Japan
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- Morita Toyohiko
- Pathology, International Medical Center of Japan
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- Saito Kiyoshi
- Pathology, International Medical Center of Japan
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- Kamei Akiko
- Yoyogi Park Clinic
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- Seo Yujong
- Divisions of Cardiology, International Medical Center of Japan
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- Kawamura Itta
- Divisions of Cardiology, International Medical Center of Japan
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- Kojima Taro
- Divisions of Cardiology, International Medical Center of Japan
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- Seki Yutaka
- Divisions of Cardiology, International Medical Center of Japan
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- Saito Kan
- Divisions of Cardiology, International Medical Center of Japan
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- Kumagai Kenta
- Divisions of Cardiology, International Medical Center of Japan
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- Ohno Kunihiko
- Divisions of Cardiology, International Medical Center of Japan
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- Tanaka Yuriko
- Divisions of Cardiology, International Medical Center of Japan
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- Itaoka Yoshinori
- Divisions of Cardiology, International Medical Center of Japan
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- Okazaki Osamu
- Divisions of Cardiology, International Medical Center of Japan
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- Izumo Kazuhide
- Divisions of Cardiology, International Medical Center of Japan
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- Kimura Sosuke
- Cardiovascular Surgery, International Medical Center of Japan
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- Akatsuka Nobuharu
- Divisions of Cardiology, International Medical Center of Japan
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- Yazaki Yoshio
- Divisions of Cardiology, International Medical Center of Japan
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Abstract
An 80-year-old woman was admitted with cardiogenic shock; she arrived in a deep coma with systolic blood pressure of 44 mmHg. An electrocardiogram showed ST elevation in I, aVL, V5 and V6, suggesting myocardial infarction in the lateral area of the left ventricle. A chest roentgenogram showed right pulmonary edema without cardiomegaly. Transthoracic and transesophageal echocardiograms revealed severe mitral regurgitation and a flailing anterior mitral valve leaflet, suggesting a ruptured papillary muscle. The patient was initially treated with high-dose dopamine, dobutamine and norepinephrine. Intraaortic balloon pumping was initiated after the patient's condition stabilized. She underwent emergency mitral valve replacement with a prosthetic valve. Complete rupture of the anterior papillary muscle was confirmed. Histological examination revealed necrosis of the anterior papillary muscle with inflammatory changes. She recovered uneventfully. Postoperative coronary angiography demonstrated subtotal occlusion of the first diagonal branch, and left ventriculography demonstrated akinesis of the lateral segment. This was a rare case in which subtotal occlusion of the first diagonal branch caused rupture of an anterior papillary muscle leading to severe mitral regurgitation. (Circ J 2002; 66: 615 - 618)<br>
Journal
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- Circulation Journal
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Circulation Journal 66 (6), 615-618, 2002
The Japanese Circulation Society
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Keywords
Details 詳細情報について
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- CRID
- 1390001205105886208
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- NII Article ID
- 110002682827
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- NII Book ID
- AA11591968
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- COI
- 1:STN:280:DC%2BD38zjtFKmtQ%3D%3D
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- ISSN
- 13474820
- 13469843
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- PubMed
- 12074285
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- Text Lang
- en
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- Data Source
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- JaLC
- Crossref
- PubMed
- CiNii Articles
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- Abstract License Flag
- Disallowed