مريض في اليوم الرابع بعد احتشاء سفلي صار عنده فجأة ضيق نفس شديد وخراخر منتشرة، وسُمعت نفخة انقباضية جديدة عند القمة. الضغط ٨٨/٥٦. ما المضاعفة الأرجح؟

On day 4 after an inferior MI, a client suddenly develops severe dyspnoea and widespread crackles, and a new apical systolic murmur is heard. BP is 88/56. What is the most likely complication?

1. Early pericarditis after the infarction
2. Dressler syndrome, an immune reaction after MI
3. Papillary muscle rupture with acute mitral regurgitation
4. Pulmonary embolism from a leg vein clot

Answer: C) Papillary muscle rupture with acute mitral regurgitation. A new apical systolic murmur with sudden pulmonary oedema and hypotension after MI means acute mitral regurgitation from papillary muscle rupture, a surgical emergency.