Diffuse Alveolar Hemorrhage due to Acute Mitral Valve Regurgitation

Creticus P Marak; Parijat S Joy; Pragya Gupta; Yana Bukovskaya; Achuta K Guddati

doi:10.1155/2013/179587

Diffuse Alveolar Hemorrhage due to Acute Mitral Valve Regurgitation

Case Rep Pulmonol. 2013:2013:179587. doi: 10.1155/2013/179587. Epub 2013 Dec 8.

Authors

Creticus P Marak¹, Parijat S Joy², Pragya Gupta³, Yana Bukovskaya⁴, Achuta K Guddati⁵

Affiliations

¹ Division of Pulmonary Medicine, Department of Medicine, Tahlequah City Hospital, Tahlequah, OK 74464, USA.
² Department of Internal Medicine, University of Iowa Hospital, University of Iowa, Iowa City, IA 52242, USA.
³ Division of Pulmonary and Critical Care Medicine, Montefiore Hospital, Albert Einstein College of Medicine, Yeshiva University, New York, NY 10467, USA.
⁴ Department of Pharmacy, Massachusetts General Hospital, Harvard Medical School, Harvard University, 50 Fruit Street, Boston, MA 02114, USA.
⁵ Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Harvard University, Boston, MA 02114, USA.

Abstract

Diffuse alveolar hemorrhage (DAH) can be caused by several etiologies including vasculitis, drug exposure, anticoagulants, infections, mitral valve stenosis, and regurgitation. Chronic mitral valve regurgitation (MR) has been well documented as an etiological factor for DAH, but there have been only a few cases which have reported acute mitral valve regurgitation as an etiology of DAH. Acute mitral valve regurgitation can be a life-threatening condition and often requires urgent intervention. In rare cases, acute mitral regurgitation may result in a regurgitant jet which is directed towards the right upper pulmonary vein and may specifically cause right-sided pulmonary edema and right-sided DAH. Surgical repair of the mitral valve results in rapid resolution of DAH. Acute MR should be considered as a possible etiology in patients presenting with unilateral pulmonary edema, hemoptysis, and DAH.