Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
A 48-year-old woman presented to our hospital with exacerbating cyanosis, edema, lethargy, and dyspnea. The patient declared amphetamine usage until 3 days earlier. Her respiratory function deteriorated gradually, resulting in intubation. During the hospitalization course, she became febrile with a positive blood culture due to an infected central venous catheter. Transesophageal echocardiography revealed a normal left ventricular systolic function, severe left ventricular hypertrophy, and a severe pulmonary arterial hypertension. We found multiple ruptured chordae, resulting in a flail mitral valve and severe mitral regurgitation. To the best of our knowledge, this is the first report of multiple ruptured chordae in the setting of amphetamine intoxication.