A 69-year-old woman with idiopathic dilated cardiomyopathy and chronic heart failure experienced repeated hospital admissions for acute pulmonary edema with no recognizable precipitating factor. Worsening mitral regurgitation was triggered by exercise echocardiography and significant intraventricular dyssynchrony was elicited by low-dose dobutamine stress echocardiography. After cardiac resynchronization therapy she remained free of hospitalizations for 12 months. This case highlights the dynamic nature of both functional mitral regurgitation and left ventricular dyssynchrony and illustrates how in some patients stress echocardiography can help to clarify clinical scenarios and help with the challenging task of selecting patients who will benefit from cardiac resynchronization therapy.
Keywords: Cardiac resynchronization therapy; Dissincronia ventricular esquerda; Ecocardiografia de stress; Functional mitral regurgitation; Left ventricular dyssynchrony; Regurgitação mitral funcional; Stress echocardiography; Terapêutica de ressincronização cardíaca.
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