Clinical images. Pulmonary edema without an obvious cause: handgrip-induced large dynamic changes in ischemic mitral regurgitation in the cath lab
Favaretto, E.; Tarantini, G.
Journal of Invasive Cardiology 22(6): 298-299
2010
ISSN/ISBN: 1557-2501 PMID: 20516513 Document Number: 645127
We report a case of pulmonary edema experienced in a patient with severe left ventricular dysfunction without an obvious cause. Thus, we tested the hypothesis of a dynamic increase in the severity of (ischemic) mitral regurgitation. Right- and left-heart cardiac catheterization was performed before and after 2 minutes of maximal handgrip. We observed an increase in the patient's left ventricular systolic and end-diastolic pressures, his pulmonary and wedge capillary pressures, his heart rate and severe mitral regurgitation.