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Chordae Tendinae Rupture

Chordae Tendinae Cordis Rupture


Presentation

  • In the present patient, flail tip of AML was not appreciated on 2D TTE apical 4-chamber view.[annals.in]
  • Completely revised and updated, this new edition of a bestseller contains entirely new cases, presented in random order, just as they would in practice.[books.google.com]
  • Metz, MD, FACP Patients with ITP continue to present difficulties in diagnosis and management. Two experts discuss the current approach to ITP.[books.google.com]
  • In this case report, the authors present a patient with false tendon rupture that mimicked intraventricular chorda rupture.[unboundmedicine.com]
  • Clinical Presentation and Diagnosis Most cardiac injuries caused by stab wounds are logically based on the trajectory of the insult.[thoracickey.com]
Dyspnea
  • The patients who had primary CTR were older (59.9 /- 1.6 v 52.1 /- 3.1 years, P .029), had a higher prevalence of hypertension (56% v 30%, P .018) and complained more often of dyspnea (82% v 53%, P .003) than the patients in the secondary group.[ncbi.nlm.nih.gov]
  • ., palpitations , fatigue, dyspnea ) may arise, especially if associated with MR . A mitral prolapse click is a classic auscultatory finding MVP and diagnosis is made with echocardiography .[amboss.com]
  • A 62-year-old male patient presented with progressive dyspnea on exertion and pedal edema since 4 years.[annals.in]
  • MVP is usually asymptomatic in the absence of significant regurgitation, although there are reports that some patients experience chest pain, dyspnea, dizziness, and palpitations.[merckmanuals.com]
  • Pulmonary edema will impair normal gas diffusion , and cause dyspnea and -if severe - may lead to death. The consequences of papillary muscle paralysis are quite similar.[hmphysiology.blogspot.com]
Congestive Heart Failure
  • But when it's severe, mitral valve regurgitation may lead to these complications : Congestive heart failure. In congestive heart failure, your heart is unable to pump sufficient blood to meet your body's needs.[knowyourdisease.com]
  • By permission from Knottenbelt DC, Pascoe RR, Diseases and Disorders of the Horse, Saunders, 2003 chorda tendineae rupture causes acute, massive, cardiac insufficiency leading to congestive heart failure and an early death; called also detachment. chorda[medical-dictionary.thefreedictionary.com]
  • Acute congestive heart failure due to ruptured mitral chordate tendineae in late pregnancy. J. Obstetric Gynaecology. Res 2013; 39(3):724-726. 4. Olivera DB, Dawkins KD, Kay PH, Paneth M. Chordal rupture. I: Aetiology and natural history.[jmscr.igmpublication.org]
  • Clinical symptoms may be summarized under the name of congestive heart failure. Beside the common symptoms of fitness depression, in severe cases rupture of chordae tendineae or heart wall result in sudden death by heart failure.[elib.tiho-hannover.de]
  • Major complications from chronic regurgitation include the following: Severe LV dysfunction Chronic congestive heart failure Atrial fibrillation and its complications (eg, left atrial thrombus with embolization and stroke) Sudden death, ruptured chordae[emedicine.medscape.com]
Anorexia
  • Mitral Valve Prolapse Familial Nonfamilial Marfan’s syndrome Other connective tissue diseases Secondary MVP Coronary artery disease Rheumatic heart disease Reduced LV dimensions Hypertrophic cardiomyopathy Atrial septal defect Pulmonary hypertension Anorexia[cdc.gov]
Ecchymosis
  • A history or findings of pain and tenderness over the anterior chest wall (which may be indistinguishable from a classic myocardial infarction), evidence of chest wall contusion, ecchymosis, anterior rib fractures, and flail chest are all associated with[thoracickey.com]
Heart Disease
  • Multiple logistic regression analysis showed four independent risk factors: TIMP2 [odds ratio (OR) 1.82, 95% confidence interval (CI) 1.18-2.81, P 0.007], hypertension (OR 2.40, CI 1.08-5.34, P 0.032), rheumatic heart disease (OR 0.18, CI 0.05-0.70, P[ncbi.nlm.nih.gov]
  • The known predisposing factors in secondary group include mitral valve prolapse, infective endocarditis, and rheumatic heart disease.[ncbi.nlm.nih.gov]
  • Sub-acute endocarditis (SBE) and rheumatic heart disease (RHD) were the most frequent causes before 1985 (54.4% and 42.1%, respectively); since 1985 SBE and RHD have dropped sharply to 37.4% and 24.8%, respectively.[ncbi.nlm.nih.gov]
  • heart disease NOS diagnostic res30: Ischaemic heart disease G5yz.00 Read other heart disease nos diagnostic res30: Ischaemic heart disease G5z..00 Read heart disease nos diagnostic res30: Ischaemic heart disease Gyu3.00 Read [x]ischaemic heart diseases[clinicalcodes.rss.mhs.man.ac.uk]
  • Some people are born with heart disease.[icdlist.com]
Tachycardia
  • […] paroxysmalis I47.1 Supraventricular tachycardia Latin: Tachycardia supraventricularis Paroxysmal tachycardia: · atrial · atrioventricular [AV] · junctional · nodal I47.2 Ventricular tachycardia Latin: Tachycardia ventricularis paroxysmalis I47.9 Paroxysmal[mkb-dijagnoza.blogspot.com]
  • The initial EKG shows sinus tachycardia with occasional premature ventricular complexes. The chest x-ray reveals no cardiomegaly, but bilateral alveolar infiltrates and hilar prominence are present.[usmleforum.com]
  • Department of Cardiovascular Surgery, Keio University School of Medicine Electrophysiological Characteristics of Localized Reentrant Atrial Tachycardia Occuring After Catheter Ablation of Long-Lasting Persistent Atrial Fibrillation Yoshihide Takahashi[j-circ.or.jp]
  • , the most common, to supraventricular arrhythmias such as atrial flutter and atrial fibrillation, ventricular tachycardia, premature ventricular contractions, ventricular fibrillation, right bundle branch block with first-degree heart block or hemiblock[thoracickey.com]
  • People with rhythm disturbances may need to be treated with beta blockers or other medications to control tachycardias (fast heart rhythms).[hopkinsmedicine.org]
Systolic Murmur
  • A systolic murmur is sometimes heard for the first time after an episode of myocardial ischemia or the occurrence of a myocardial infarction.[jamanetwork.com]
  • Thoracic auscultation revealed a grade V/VI systolic murmur with maximal intensity over the left apex characterized by musical murmur. Echocardiography revealed mild myxomatous degeneration of mitral valve and ruptured chordae tendineae.[pesquisa.bvsalud.org]
  • The systolic click moves toward the first heart sound with upright posture and the systolic murmur becomes longer and often louder; a systolic murmur may be present only in the upright position.[karger.com]
  • Signs include a crisp mid-systolic click, followed by a late systolic murmur if regurgitation is present. Diagnosis is by physical examination and echocardiography.[merckmanuals.com]
  • On auscultation of the heart, an early, decrescendo, systolic murmur at the cardiac apex is heard; the murmur decreases with Valsalva maneuver, and increases with the grip maneuver, radiating to the axilla.[usmleforum.com]
Heart Murmur
  • Heart murmur was age and sex-dependent. Separate auscultatory findings led to a prevalence of 44.95% in Cavalier King Charles spaniels. In addition to age- and sex-dependance, thorax circumference correlated negatively with heart murmur.[elib.tiho-hannover.de]
  • Gejala-Gejala Dari Heart Murmur Heart murmur tidak menyebabkan gejala-gejala dan umumnya tidak dapat didengar oleh orang yang terpengaruh.[ariputuamijaya.wordpress.com]
  • Overview In most cases MVP is completely asymptomatic and is discovered incidentally due to auscultation of a characteristic "Mid-systolic Click" followed by a late systolic heart murmur.[pathwaymedicine.org]
  • Mitral valve regurgitation can cause an abnormal heart sound (heart murmur). Your doctor may have already informed you that you have a heart murmur caused by mitral valve regurgitation.[knowyourdisease.com]
  • The only other heart murmur that follows this pattern is the murmur of hypertrophic cardiomyopathy .[en.wikipedia.org]
Late Systolic Murmur
  • Signs include a crisp mid-systolic click, followed by a late systolic murmur if regurgitation is present. Diagnosis is by physical examination and echocardiography.[merckmanuals.com]
  • Barlow JB, Pocock WA, Marchand P, et al: The significance of late systolic murmurs. Am Heart J 1963;66:443-452. Criley JM, Kissel GL: Prolapse of the mitral valve: the click and late systolic murmur syndrome. Progr Cardiovasc Dis 1975;4:23-36.[karger.com]
  • Michael Criley . [3] Signs and symptoms [ edit ] Murmur [ edit ] Upon auscultation of an individual with mitral valve prolapse, a mid-systolic click, followed by a late systolic murmur heard best at the apex is common.[en.wikipedia.org]

Workup

  • The authors include pertinent questions with each case to guide you through the case workup and treatments with in-depth answers for each case in the second half of the book. They provide a short list of pertinent references after most cases.[books.google.com]
  • Chest radiography is performed on hemodynamically stable patients, and a widened mediastinum signifies the need for further workup.[thoracickey.com]

Treatment

  • Etiology Pathophysiology Clinical features Diagnostics Treatment Complications We list the most important complications. The selection is not exhaustive.[amboss.com]
  • Treatment Usually none Sometimes beta-blockers Mitral valve prolapse does not usually require treatment.[merckmanuals.com]
  • Covers the hottest topics shaping today's practice, including the latest theory and surgical techniques for mitral valve disease, advances in the treatment of congenital heart disease, minimally invasive surgical approaches to the treatment of adult and[books.google.ro]
  • Patients with EF 60% on medical treatment.[revespcardiol.org]
  • Treatment If you have a really mild case, you might need no treatments at all. Your doctor will still want to keep a watchful eye on you with regular checkups.[webmd.com]

Prognosis

  • Prognosis Mitral valve prolapse is usually benign, but severe myxomatous degeneration of the valve can lead to MR.[merckmanuals.com]
  • The clinical manifestations, management strategies, and prognosis were investigated. Eighty-one (85%) patients were between 4 and 6 months (median, 5 months) of age. In 63 (66%) patients, rupture occurred during the spring or summer.[keio.pure.elsevier.com]
  • Ischemic MR carries a worse prognosis and the risk of surgery is higher.[revespcardiol.org]
  • The prognosis of these patients is good; however, sudden death, endocarditis , and progressive regurgitation occur rarely.[emedicine.medscape.com]
  • What is the prognosis for Mitral Valve Prolapse? This condition is usually harmless and does not shorten life expectancy. Healthy lifestyle behaviors and regular exercise are encouraged.[hopkinsmedicine.org]

Etiology

  • Several factors have been implicated in the etiology of ruptured chordae tendineae. The first report by Corvisart (1) in FULL TEXT[annals.org]
  • Pathogenesis Etiology Inflammatory and degenerative changes in the chordae.[vetstream.com]
  • Etiology Pathophysiology Clinical features Diagnostics Treatment Complications We list the most important complications. The selection is not exhaustive.[amboss.com]
  • Abstract To determine the causes of ruptured chordae tendineae and a suspected etiologic role for mitral valve prolapse (MVP), the mitral valve in 25 consecutive and surgically proved cases of chordal rupture were examined.[14a.corrode.us]
  • Although active bacterial endocarditis was probably the major cause of ruptured chordae tendineae in the preantibiotic era, 2 rheumatic mitral valvulitis, often with healed bacterial endocarditis, appears to be the most common etiology at present. 3 4[nejm.org]

Epidemiology

  • Epidemiology References: [1] Epidemiological data refers to the US, unless otherwise specified. Etiology Pathophysiology Clinical features Diagnostics Treatment Complications We list the most important complications. The selection is not exhaustive.[amboss.com]
  • Epidemiology and Genetics of Chronic Mitral Valve Disease in Cavalier King Charles spaniels in Germany publication Hannover, Tierärztliche Hochschule, Dissertation, 2003 text /dissertations/hagelt_2003.pdf abstract (deutsch) Die Chronische Mitralklappeninsuffizienz[elib.tiho-hannover.de]
  • "Pectus Excavatum: Epidemiology" . Medscape . Retrieved 14 April 2016 . a b c d e f g h Playford, David; Weyman, Arthur (2001). "Mitral valve prolapse: time for a fresh look" . Reviews in Cardiovascular Medicine . 2 (2): 73–81.[en.wikipedia.org]
  • Epidemiology Frequency United States Previously, chronic rheumatic heart disease was the most common cause of acquired mitral valve disease in the Western world.[emedicine.medscape.com]
  • Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes 6:1246-1258. Lu KJ, Kearney LG, Ord M, et al. 2013.[journal.hsforum.com]
Sex distribution
Age distribution

Pathophysiology

  • Etiology Pathophysiology Clinical features Diagnostics Treatment Complications We list the most important complications. The selection is not exhaustive.[amboss.com]
  • We remain committed to the case method of instruction, and believe that there is no better method to learn medicine than to have an individual patient problem as the basis for study of pathophysiology, natural history, diagnosis and management.[books.google.com]
  • Although often asymptomatic, MVP can lead to the development of the general pathophysiological phenomenon of mitral regurgitation (Do not confuse these two terms).[pathwaymedicine.org]
  • […] of Cardiac Tamponade Clinical Signs Associated with Pericardial Effusion Diagnosis of Pericardial Effusion Pericardiocentesis Postpericardiocentesis Monitoring Complications of Pericardiocentesis Summary Pathophysiology of Microcirculatory Dysfunction[books.google.com]
  • Pathophysiology Chordae anchor valve cusps to papillary muscles. Degenerative change rupture valvular incompetence clinical signs of heart failure. Spontaneous rupture often occurs in horses with no obvious predisposing cause.[vetstream.com]

Prevention

  • The tendinous chords pull the flaps or cusps of the valves and prevent them from swinging back into the upper chamber of the heart.[knowyourbody.net]
  • The chordae tendineae prevent the eversion, prolapse , by becoming tense thus pulling the flaps, holding them in closed position. [1] Additional images [ edit ] Papillary muscles and chordae tendineae Ultrasound showing redundant chordae tendineae [2][en.wikipedia.org]
  • Local LV remodeling with papillary muscle displacement (both the dilatation of the ventricle and the akinesis/dyskinesis of the wall to which the papillary muscle is attached can prevent adequate leaflet coaptation).[unboundmedicine.com]
  • Following a low-salt diet helps prevent fluid buildup and helps control blood pressure. Antibiotics are used to help prevent endocarditis. If you have mitral valve regurgitation, always follow precautions to prevent endocarditis.[knowyourdisease.com]
  • The AV valves prevent regurgitation by covering the openings to the atria and forcing blood to exit the heart.[innerbody.com]

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