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Mitral valve dysfunction in a woman with newly diagnosed acute promyelocytic leukemia
  1. Matthew J Bierowski,
  2. Eric D Warner,
  3. Chelsea D Edirisuriya
  1. Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Matthew J Bierowski, Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA; matthew.bierowski{at}jefferson.edu

https://doi.org/10.1136/heartjnl-2023-323604

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    Clinical introduction

    A woman in her mid-40s with a recent diagnosis of pulmonary embolism (on rivaroxaban) presented to the emergency room with dyspnea and fatigue. Vital signs were stable on arrival but a new holosystolic murmur was noted on exam and labs revealed pancytopenia. Infectious workup was unrevealing. CT revealed stable pulmonary emboli compared with prior imaging, along with a new splenic infarct. Transthoracic echocardiography (TTE) (figures 1 and 2, online supplemental video 1) demonstrated new findings since the patient’s last normal TTE 3 months prior. Following hospital admission, the patient underwent a bone marrow biopsy which was consistent with acute promyelocytic …

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    Footnotes

    • Contributors All authors contributed to the medical care of the patient and preparation of this manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.