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Park, Kang, Choi, Park, Jeung, Hur, Lee, Yum, Lee, Jang, Kim, and Choi: A Case of Pulmonary Edema by Idiopathic Rupture of Mitral Chordae Tendinae
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Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 63(5): 458-461.

Published online: 30 November 2007

DOI: https://doi.org/10.4046/trd.2007.63.5.458

A Case of Pulmonary Edema by Idiopathic Rupture of Mitral Chordae Tendinae

Hye Kyeong Park, M.D.1, Yeun Jeong Kang, M.D.1, Sang Bong Choi, M.D.1, I Nae Park, M.D.1, Hoon Jeung, M.D.1, Jin Won Hur, M.D.1, Hyun Kyung Lee, M.D.1, Ho Kee Yum, M.D.1, Hyuk Pyo Lee, M.D.1, Ji Min Jang, M.D.2, Joung Sook Kim, M.D.3, Soo Jeon Choi, M.D.1

1Department of Internal Medicine, Inje University College of Medicine, Paik Hospital, Seoul, Korea.

2Department of Chest Surgery, Inje University College of Medicine, Paik Hospital, Seoul, Korea.

3Department of Radiology, Inje University College of Medicine, Paik Hospital, Seoul, Korea.

Address for correspondence: Soo Jeon Choi, M.D. Department of Internal Medicine, Inje University Collage of Medicine, Sanggye-Paik Hospital, 761, Sanggye 7-dong, Nowon-gu, Seoul 139-707, Korea. Phone: 82-2-950-1990, Fax: 82-2-950-1955, choisj@sanggyepaik.ac.kr

Received 31 August 2007       Accepted 26 October 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

The typical radiographic findings of pulmonary edema from the increased hydrostatic pressure shows centrally localized consolidation, which is known as a "butterfly or bat's wing" pattern. These terms describe the anatomic distribution of edema that uniformly involve the hilum and medulla of the lung but not the peripheral region of the lung parenchyma (cortex). We present a case of butterfly wing-like pulmonary edema on a chest radiograph by mitral regurgitation due to an idiopathic chordal rupture.

Keywords: Pulmonary edema, Mitral regurgitation, Chordae tendineae

Figures and Tables

Figure 1
(A) Chest PA shows bilateral peribronchial consolidation more prominent in right lung with small amount of pleural effusion in both costophrenic angles. (B) Thin-section Chest CT demonstrates bilateral diffuse consolidation and ground glass opacities sparing subpleural lung zone.
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Figure 2
Long-axis parasternal view of two-dimensional echocardiogram during early systole demonstrates mitral regurgitant jet flow toward the left atrial appendage and mitral valve prolapse.
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Figure 3
Thoracotomy view reveals the posterior leaflet of mitral valve (arrow) and multiple rupture of chordae tendinae (arrowhead).
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Figure 4
Follow-up chest PA after mitral valve replacement and chordal repair shows decreased cardiomegaly with near completely resorbed pulmonary edema and pleural effusion.
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References

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