Clinical practice and cases in emergency medicine · 2025
Anterior Mitral Leaflet Flutter on M-mode Echocardiography as an Indicator of Atrial Fibrillation: Case Report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Alexandri Maya, Church Adam, Ausman Chelsea, Brillhart Dan
Аннотация
INTRODUCTION: M-mode in bedside point-of-care ultrasound (POCUS) transthoracic echocardiography (TTE) remains an important tool for emergency physicians. M-mode of the mitral valve is used to assess ejection fraction (EF) during assessment of E-point septal separation (EPSS). Anterior mitral leaflet fluttering visualized on M-mode echocardiography is a known sequela of aortic regurgitation. Although not previously reported in the emergency medicine (EM) literature, anterior mitral leaflet fluttering also occurs with atrial fibrillation.
CASE REPORT: We present the first case in peer-reviewed EM literature of anterior mitral leaflet fluttering observed on M-mode echocardiography caused by atrial fibrillation. Our patient was a 54-year-old male who had a POCUS TTE that showed anterior mitral leaflet fluttering on EPSS. Subsequent inpatient workup confirmed the diagnosis of symptomatic atrial fibrillation without ischemia or clinically significant aortic regurgitation.
CONCLUSION: Emergency physicians must rapidly assess and risk-stratify undifferentiated patients presenting with chest pain. Understanding that anterior mitral leaflet fluttering on M-mode during E-point septal separation may signal atrial fibrillation augments efficient and appropriate disposition of these patients.
CASE REPORT: We present the first case in peer-reviewed EM literature of anterior mitral leaflet fluttering observed on M-mode echocardiography caused by atrial fibrillation. Our patient was a 54-year-old male who had a POCUS TTE that showed anterior mitral leaflet fluttering on EPSS. Subsequent inpatient workup confirmed the diagnosis of symptomatic atrial fibrillation without ischemia or clinically significant aortic regurgitation.
CONCLUSION: Emergency physicians must rapidly assess and risk-stratify undifferentiated patients presenting with chest pain. Understanding that anterior mitral leaflet fluttering on M-mode during E-point septal separation may signal atrial fibrillation augments efficient and appropriate disposition of these patients.