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Case Reports
. 2020 Jul 24;12(7):e9374.
doi: 10.7759/cureus.9374.

Emergent Diagnosis of a Flail Mitral Leaflet With Bedside Echocardiography

Patrick Hsu  1 , Caroline Shepherd  1 , Keyon Shokraneh  1 , Gabriel Cabrera  1 , Eric J Kalivoda  1
Affiliations
Case Reports

Emergent Diagnosis of a Flail Mitral Leaflet With Bedside Echocardiography

Patrick Hsu et al. Cureus. .

Abstract

Flail mitral leaflet (FML) with associated acute pulmonary edema and acute decompensated heart failure is an emergent condition requiring prompt recognition by the emergency physician (EP). Focused cardiac ultrasound (FOCUS) and lung ultrasound (LUS) have a vital role in the evaluation of FML in the emergency department. This case report describes the identification of a FML with EP-performed bedside echocardiography.

Keywords: echocardiography; emergency department; flail mitral leaflet; focused cardiac ultrasound; mitral regurgitation; point-of-care ultrasound.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Point-of-care lung ultrasound demonstrating a B-line profile (white lines).
Figure 2
Figure 2. Bedside transthoracic echocardiogram (parasternal long-axis window) demonstrating a flail posterior mitral leaflet (solid arrow) and left atrial dilation (dotted arrow).
Ao, aortic root; LA, left atrium; LV, left ventricle.
Figure 3
Figure 3. Bedside transthoracic echocardiogram (apical window) demonstrating a flail posterior mitral leaflet (arrow).
LA, left atrium; LV, left ventricle.
Figure 4
Figure 4. Comprehensive transthoracic echocardiogram (parasternal long-axis window) with color Doppler demonstrating flail motion of the posterior mitral leaflet and a severe eccentric mitral regurgitant jet (arrows).
Ao, aortic root; LA, left atrium; LV, left ventricle.
Figure 5
Figure 5. Comprehensive transthoracic echocardiogram (apical four-chamber window) demonstrating (A) flail motion of the posterior mitral leaflet and (B) severe eccentric mitral regurgitant jet (arrows).
RA, right atrium; RV, right ventricle; LA, left atrium; LV, left ventricle.
Figure 6
Figure 6. Transesophageal echocardiogram demonstrating normal position of the anterior mitral leaflet (rightward-pointing arrow) and flail motion of the posterior mitral leaflet (leftward-pointing arrow).
Ao, aortic root; LV, left ventricle; LA, left atrium.
See this image and copyright information in PMC

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