Question 問題：

Acute MR, a life-threatening complication of MI, is a cardiac emergency as it presents with sudden onset flash pulmonary edema, hypotension, and cardiogenic shock. Does the lack of murmur essentially exclude the diagnosis? Why/why not??

急性二尖瓣返流，一個心肌梗塞危及生命的合并癥，是心臟急診，因為它通常表現(xiàn)為突發(fā)危重肺水腫，低血壓，和心源性休克。沒有心臟雜音基本上可以排除這個診斷嗎？為什么能/為什么不能？

Answer 答案：

50% of patients with acute moderate to severe MR hAVe no audible murmur. Severe MR may be silent because reduced ventricular function minimizes the AV gradient, regurgitant flow, and subsequent murmur (Cureus. 2021;13:e13996).?

50%中重度二尖瓣返流患者沒有可聽見的雜音。由于降低的心室功能最大程度上減低了房室壓差，返流流量，及相應(yīng)的雜音，嚴(yán)重二尖瓣返流可能是無雜音的。

參考文獻：

Cureus. 2021;13:e13996