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Postgraduate Education Corner: PULMONARY AND CRITICAL CARE PEARLS |

A 55-Year-Old Man With a Prosthetic Mitral Valve and Multiorgan Failure*

Irini Mavrou, MD; Ioanna Dimopoulou, MD; Michalis Lignos, MD; Loukianos Rallidis, MD; Apostolos Armaganidis, MD; Petros Kopterides, MD
Author and Funding Information

*From the 2nd Critical Care Department (Drs. Mavrou, Dimopoulou, Lignos, Armaganidis, and Kopterides) and the Cardiology Department (Dr. Rallidis), “Attikon” University Hospital, Medical School of Athens University, Athens, Greece.

Correspondence to: Petros Kopterides, MD, 28-30 Korai St, Nea Ionia, Athens 14233, Greece; e-mail: petkop@ath.forthnet.gr



Chest. 2006;130(5):1617-1619. doi:10.1378/chest.130.5.1617
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A 55-year-old man with a history of mitral valve replacement (CarboMedics; Austin, TX) due to rheumatic disease was transferred to our ICU from an outside hospital with multiorgan failure. Five days earlier, he had begun to complain of dyspnea at rest along with a low-grade fever and was admitted to another institution with clinical and radiologic findings compatible with pulmonary edema. Despite the intensive medical treatment (ie, inotropes, diuretics, and broad-spectrum antibiotics), his condition deteriorated rapidly, and severe hypoxemic respiratory failure developed 2 days later, requiring mechanical ventilation. In addition, he became anuric and was started on renal replacement therapy, requiring high doses of inotropes and vasopressors in order to keep his systolic BP at barely > 75 mm Hg. Thus, he was transferred to our ICU in an extremely critical condition for further workup and treatment.

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