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June 17, 2026BMJ Case Reports0 citations

Acute severe mitral regurgitation mimicking pneumonia: the diagnostic value of echocardiography

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MTMariana Martins TeixeiraBVBeatriz VieiraABAna Belinha

Key Result

Bedside echocardiography identified acute severe mitral regurgitation due to chordae tendineae rupture in a patient misdiagnosed with pneumonia, leading to successful surgical repair and recovery.

Key Points

  • This report aims to highlight the diagnostic challenges of acute severe mitral regurgitation that can mimic pneumonia symptoms.
  • Presented a case involving a man in his early 60s admitted for acute hypoxaemic respiratory failure.
  • Utilized bedside echocardiography to assess cardiac conditions in the presence of respiratory distress.
  • Initiated targeted medical management followed by surgical intervention for diagnosis confirmation and treatment.
  • The patient was misdiagnosed with severe pneumonia based on chest opacity and inflammatory markers.
  • Echocardiography revealed acute severe mitral regurgitation due to chordae tendineae rupture.
  • The patient underwent successful surgical repair and achieved full clinical recovery.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
1 man in his early 60s presenting with acute hypoxaemic respiratory failure initially misdiagnosed as pneumonia, found to have acute severe mitral regurgitation.
I
Intervention
Bedside echocardiography followed by targeted medical management and definitive surgical repair.
O
Outcome
Identification of acute severe mitral regurgitation and clinical recovery.

This case highlights the critical diagnostic value of early bedside echocardiography in differentiating acute valvular disease from pulmonary infection in patients with unexplained respiratory failure.

Abstract

Acute hypoxaemic respiratory failure is frequently attributed to primary pulmonary pathology, particularly in the presence of radiographic abnormalities and inflammatory markers. Cardiac conditions, however, may present with similar features and lead to diagnostic error. We report the case of a man in his early 60s admitted with acute hypoxaemic respiratory failure, initially diagnosed with severe community-acquired pneumonia on the basis of unilateral chest opacity and an apparent inflammatory response. Despite empirical antibiotic therapy, his respiratory status deteriorated. Bedside echocardiography identified acute severe mitral regurgitation due to rupture of the posterior mitral leaflet chordae tendineae. Targeted medical management was initiated, followed by definitive surgical repair with full clinical recovery. This case highlights the potential for acute valvular disease to mimic pulmonary infection and the importance of early echocardiographic assessment in patients with unexplained respiratory failure.

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Cite This Study

Teixeira et al. (2026) conducted a case report in Acute severe mitral regurgitation (n=1). Bedside echocardiography and surgical repair was evaluated on Clinical recovery. Bedside echocardiography identified acute severe mitral regurgitation due to chordae tendineae rupture in a patient misdiagnosed with pneumonia, leading to successful surgical repair and recovery.

synapsesocial.com/papers/6a32689f9da909cb8f3dcc81https://doi.org/10.1136/bcr-2026-274025
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