ABC | Volume 114, Nº4, Suplement, April 2020

Anatomopathological Correlation Favarato & Benvenuti Heart failure after myocardial infarction an rupture of chordae tendineae Arq Bras Cardiol 2020; 114(4Suppl.1):47-56 Figure 4 - Chest radiography - right perihilar condensation and right cardiac border, signs of pulmonary congestion and cardiomegaly. Figure 5 - ECG showing left atrial overload, right bundle branch block. The patient received antibiotic therapy with vancomycin and meropenem and as there was clinical improvement, she was discharged on April 19, 2017. On May 21, 2017, she returned to the InCor Emergency Department due to worsening dyspnea, now with orthopnea and lower-limb edema. Moreover, she had had anuria for one day. She also complained of daily vomiting and diarrhea since the second hospital discharge. Five days before this hospitalization, she had been treated at an outpatient clinic and, due to suspected pseudomembranous colitis, she received a prescription for ciprofloxacin and metronidazole. Physical examination disclosed a respiratory rate of 22 breaths per minute, heart rate of 134 bpm, blood pressure was 105x80 mm Hg, oxygen saturation 98% under 2L / min of O 2 . Pulmonary auscultation showed crackling rales up to the middle third; the heart rate rhythm was regular, without murmurs; the abdomen showed a slight distension, with 50