Cardiology

Answer 4 VSR. It is important to recognize cardiogenic shock due to mechanical complications of MI. In this case, pulmonary artery catheterization with oximetry shows stepped-up oxygen saturation in the right ventricle and pulmonary artery that usually occurs with VSR. Although acute mitral regurgitation may cause stepped-up saturations on oximetry, it is usually seen in the peripheral pulmonary arteries and is associated with giant V waves on pulmonary artery tracings. Cardiac rupture usually has a very abrupt course with chest pain, syncope, and sudden death, whereas ventricular aneurysm or pseudoaneurysm alone may not cause a new-onset systolic murmur. VSR usually occurs after 2 to 5 days of acute MI but may also occur in the first 24 hours after MI. Echocardiography with color flow imaging can confirm the diagnosis. Click here to return to the questions

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