A young female presented to our emergency department with sudden-onset shortness of breath and orthopnea. Her condition rapidly worsened. She developed severe respiratory failure and cardiogenic shock ensued. Noticeably, the patient's CT scan showed a unique pattern of right-sided unilateral pulmonary edema, a feature highly specific for severe mitral regurgitation. Echocardiography confirmed papillary muscle rupture and acute mitral valve prolapse to be the cause. Her condition improved significantly after mitral valve replacement and with respiratory and circulatory support, as well as with other heart failure treatment. The classic symptoms of acute left heart failure combined with the unique CT manifestation of predominantly right-sided pulmonary edema suggested severe mitral regurgitation. Prompt diagnosis and early initiation of treatment aimed at the underlying cause is of great significance in improving the patient's prognosis.
患者青年女性，因突发胸闷、不能平卧来诊，以迅速进展的呼吸衰竭及心源性休克为主要临床特点，结合心脏超声结果，考虑病因为乳头肌断裂、急性二尖瓣脱垂，患者CT表现为独特的右侧为主的肺水肿，该CT表现对重度二尖瓣关闭不全有较高的诊断特异性。经过瓣膜置换、呼吸循环支持、抗心力衰竭治疗后，肺部阴影明显改善。结合急性左心力衰竭的临床症状、独特的右侧为主的肺水肿CT表现，及时想到重度二尖瓣关闭不全的诊断，尽早针对病因进行治疗，对改善患者预后有重要的意义。.