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A Rare Cause of Cardiogenic Shock: A Case Report of Aortic Regurgitation due to Rupture of a Fibrous Strand Suspending a Tricuspid Aortic Valve - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/34712880/
2021 Aug 12;5(5):335-339. doi: 10.1016/j.case.2021.07.006. 1 Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 2 Department of Cardiothoracic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 3 Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
• Source: CASE
• Conclusion/Relevance: “Fibrous strand rupture is a rare cause of acute life-threatening AR. After ruling out more apparent causes of acute AR [aortic regurgitation], recognition and subsequent acute intervention are required.”
• In the current case, a 73-year-old man presented to the emergency department due to sudden onset of circulatory shock. He had a previous medical history of hypertension, a dilated sinus of Valsalva (47 mm), and a dilated ascending aorta (45 mm). Physical exam demonstrated deep shock (blood pressure, 65/45 mm Hg; pulse, 100 bpm; lactic acid, 3.6 g/L). Global ischemia was shown on ECG.
• The authors suggested that a congenital fibrous strand ruptured, which was derived from the aortic wall and suspending the aortic valve apparatus. This event resulted in acute AR. This rupture was potentially caused by the progressive dilation of the sinus of Valsalva and ascending aorta, and exacerbated by hypertension. Cause by infective endocarditis was ruled out via clinical examination, echocardiography, blood cultures, and valve cultures.