A 31-year-old woman complained of dyspnea and orthopnea at 38 weeks of gestation. A grade 3/6 pansystolic murmur was heard, and echocardiography revealed severe mitral regurgitation with a hyperechoic obstacle on the posterior mitral valve leaflet, consistent with a diagnosis of acute heart failure due to a ruptured chordae tendineae or an infectious endocarditis. An emergency cesarean section was performed under general anesthesia. A male infant was born weighing 2928 g with Apgar scores of 7 and 8 at 1 and 5 min, respectively. The patient was managed in the intensive care unit and underwent open-heart surgery for mitral valve repair on postpartum day 3. The two chordal tendineae appeared torn and frail, and a mitral annuloplasty was performed. No finding of infectious endocarditis was observed. Because it is a dramatic and life-threatening clinical situation, proper diagnosis and treatment in the intensive care unit assure a good outcome for both mother and fetus.

译文

:一名31岁妇女在妊娠38周时主诉呼吸困难和正气呼吸。听到了3/6级的收缩期杂音,超声心动图显示二尖瓣反流严重,二尖瓣后叶上有高回声障碍,与诊断为腱索破裂或感染性心内膜炎导致的急性心力衰竭相符。全身麻醉下进行紧急剖宫产。一名男婴出生时体重为2928微克,在1分钟和5分钟时Apgar得分分别为7和8。患者在重症监护病房接受治疗,并在产后第3天接受心脏直视手术以修复二尖瓣。两个腱腱均出现撕裂和脆弱,并进行了二尖瓣瓣环成形术。没有发现感染性心内膜炎。由于这是一种戏剧性且危及生命的临床情况,因此在重症监护室进行正确的诊断和治疗可确保母亲和胎儿均获得良好的治疗效果。

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