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Dennis M. Manning, MD
Mercy Hospital of Pittsburgh

JAMA. 1986;256(20):2816.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

I read, with interest and appreciation, the article entitled "Early Repair of Mechanical Complications After Acute Myocardial Infarction" by Nishimura et al.¹ The authors' emphasis on the need for aggressive medical and surgical management is appropriate, as I have had a similar experience at my institution.

Report of a Case.—

I recently encountered a 69-year-old man with acute pulmonary edema and cardiogenic shock during an inferior myocardial infarction, in whom only a grade 2/6 systolic murmur was heard at the lower left sternal border. I delayed in the diagnosis of acute severe mitral regurgitation because of the absence of a v wave on his pulmonary artery occlusive tracing. During the subsequent catheterization of the left side of the heart, 4+ mitral regurgitation was found using a pigtail catheter in good position in the left ventricle. The left ventricular function on the left ventricular angiogram was surprisingly . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Senior Contributing Editor; Sharon Iverson, Assistant Editor.

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