Thyrotoxicosis-Induced Chordal Rupture Causing Severe Mitral Regurgitation

Figures

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  Figure 1. Preoperative Echocardiographic Assessment of Severe Mitral Regurgitation (A) Preoperative transesophageal echocardiography. Color Doppler demonstrates a flail anterior mitral leaflet with ruptured chordae tendineae and a centrally directed severe regurgitant jet. The left atrium is markedly dilated, consistent with structural mitral regurgitation. (B) Continuous-wave Doppler across the mitral valve on transesophageal echocardiography. The dense, holosystolic regurgitant jet directed toward the probe is consistent with severe mitral regurgitation.

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  Figure 2. Coronary Angiography Showing Normal Epicardial Coronary Arteries Coronary angiography demonstrating a normal right coronary artery (A), as well as a normal left main, left anterior descending, and circumflex arteries with no obstructive disease (B).

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  Figure 3. Postoperative Echocardiographic Evaluation of Bioprosthetic Mitral Valve Function (A) Postoperative transthoracic echocardiography. Apical four-chamber view showing the bioprosthetic mitral valve in place. Grayscale imaging (left) demonstrates normal prosthetic leaflet excursion and appropriate seating of the valve. Color Doppler imaging (right) shows central, laminar diastolic inflow without paravalvular leak or central regurgitation, consistent with a well-functioning mitral bioprosthesis. (B) Continuous-wave Doppler across the mitral bioprosthesis demonstrating laminar inflow with low transmitral gradients, consistent with normal prosthetic function.

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  Visual Summary. Timeline of Thyrotoxicosis-Induced Chordal Rupture and Surgical Recovery Chronological overview of the patient's presentation, stabilization, surgical management, and recovery demonstrating progression from severe mitral regurgitation secondary to thyrotoxicosis to full postoperative and biochemical recovery.