{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T17:28:31Z","timestamp":1772213311345,"version":"3.50.1"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Mitral regurgitation (MR) poses challenges in distinguishing acute from chronic aetiologies in compensated patients. A 48-year-old male rugby player presented with 2 weeks of worsening dyspnoea on a background of chronic bilateral lower limb cellulitis. Found in atrial fibrillation, transoesophageal echocardiography revealed flail P2 with severe MR, ejection fraction 35%, and severe left ventricular dilation\u2014indicating chronicity despite acute symptoms. He underwent urgent mitral valve repair. Post-induction instability necessitated emergency cardiopulmonary bypass. Repair consisted of P2 triangular resection, neochordae, and Cosgrove annuloplasty band. Weaning failed; central veno-arterial extracorporeal membrane oxygenation was instituted with open chest. Decannulated day 4, complications included anuric acute kidney injury requiring dialysis, pneumonia, and critical illness myopathy. Ejection fraction improved to 30% on medical therapy. This case underscores risks of presuming acute MR in athletes with chronic remodelling, where perioperative decompensation can precipitate shock. Preoperative haemodynamic optimization is critical to mitigate such events.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf1089","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T12:41:18Z","timestamp":1770295278000},"source":"Crossref","is-referenced-by-count":0,"title":["Acute versus chronic mitral regurgitation: a case of perioperative cardiogenic shock in an athlete"],"prefix":"10.1093","volume":"2026","author":[{"given":"Ross","family":"Walsh","sequence":"first","affiliation":[{"name":"Royal College of Surgeons of Ireland , 123 St Stephen's Green, Dublin 2 D02 YN77 ,","place":["Ireland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5451-9854","authenticated-orcid":false,"given":"Jamie","family":"Walsh","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons of Ireland , 123 St Stephen's Green, Dublin 2 D02 YN77 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