Acute Severe Primary Mitral Regurgitation with Hemodynamic Decompensation in Mitral Valve Prolapse
When mitral valve prolapse results in acute severe primary mitral regurgitation, the clinical picture shifts rapidly to a hemodynamic emergency. This presentation is distinct from chronic compensated disease and demands immediate assessment and action.
Clinical Scenario
Acute severe primary mitral regurgitation — which may arise from chordal rupture — typically causes acute hemodynamic decompensation. The symptomatic patient in this setting faces a life-threatening situation that is not amenable to watchful waiting.
Treatment Approach
Prompt surgical intervention on the mitral valve is the cornerstone of management in this emergency scenario. The complete protocol — including the preferred operative approach and the full decision algorithm — is available in the structured regimen.
References
DOI: 10.1161/CIR.0000000000000923
The patient with severe acute MR, which might occur from chordal rupture, usually experiences acute hemodynamic decompensation.
Prompt mitral valve surgery, preferably mitral repair if possible, is lifesaving in the symptomatic patient with acute severe primary MR.
However, most patients with acute severe MR require surgical correction for reestablishment of normal hemodynamics and for relief of symptoms.
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