We report a 13-year-old girl with acute pulmonary edema due to severe acute Mitral
regurgitation because of rupture of Mitral valve´s posteromedial papillary muscle. She
had normal mitral valve with necrotic posteromedial papillary muscle, classic
aneurysms in left coronary artery, neutrophilic infiltration in the wall of medium-sized
vessel of kidney and positive perinuclear antineutrophil cytoplasmic antibodies (PANCA)
a diagnosis of polyarteritis nodosa. She treated successfully with mitral valve
replacement. (Rawal Med J 2008;33:112-114).
Key words: Mitral valve, P-ANCA, Papillary muscle, polyarteritis nodosa.
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