Tuberc Respir Dis.  2007 Nov;63(5):458-461. 10.4046/trd.2007.63.5.458.

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

• Park HK
• Kang YJ
• Choi SB
• Park IN
• Jeung H
• Hur JW
• Lee HK
• Yum HK
• Lee HP
• Jang JM
• Kim JS
• Choi SJ

• KMID: 2050482
• DOI: http://doi.org/10.4046/trd.2007.63.5.458

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.

Keyword

Pulmonary edema; Mitral regurgitation; Chordae tendineae

MeSH Terms

Butterflies
Chordae Tendineae
Edema
Hydrostatic Pressure
Lung
Mitral Valve Insufficiency
Pulmonary Edema*
Radiography, Thoracic
Rupture*

Figure

• 

  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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