14 February 2013
Am J Case Rep 2013; 14:38-42
Background: Papillary muscle rupture is one of the catastrophic mechanical complications following myocardial infarction. Rupture leads to acute mitral valve regurgitation, pulmonary edema, and cardiogenic shock. Survival is dependent on prompt recognition and surgical intervention.
Cases Report: We present two cases where acute myocardial infarction was complicated by papillary muscle rupture resulting in severe mitral regurgitation and cardiogenic shock. In both cases rupture occurred within one week of infarction. Both patients did not receive coronary revascularization; one patient presented late after the onset of chest pain, the other patient percutaneous revascularization attempted and was not successful. Both patients suffered an inferior wall infarction. Echocardiogram demonstrated severe mitral regurgitation with a jet directed posteriorly. In both cases rupture of the posteromedial papillary muscle resulted in flail of the anterior mitral valve leaflet, thus serving as a reminder that both the anterior and the posterior leaflets attach to both papillary muscles.
Conclusions: While one case had a good outcome, the other reinforces the fact that this is a very serious complication requiring prompt recognition and treatment.
Keywords: Mitral Valve, flail anterior leaflet, Papillary Muscles - injuries, Myocardial Infarction - complications
22 September 2022 : Case reportRare Case of Persistently Depressed T Lymphocyte Subsets After SARS-CoV-2 Infection
Am J Case Rep In Press; DOI: 10.12659/AJCR.937760
22 September 2022 : Case reportCentral Retinal Vein Occlusion After Discontinuation of Rivaroxaban Therapy in a Young Patient with COVID-1...
Am J Case Rep In Press; DOI: 10.12659/AJCR.937739
19 September 2022 : Case reportInhaled Nitric Oxide in Acute Severe Pulmonary Hypertension and Severe Acute Respiratory Distress Syndrome ...
Am J Case Rep In Press; DOI: 10.12659/AJCR.937147
26 Sep 2022 : Case reportAn Infant Presenting with Interstitial Lung Disease Diagnosed Later as Hunter Syndrome: A Case Report
Am J Case Rep In Press; DOI: 10.12659/AJCR.937527
26 Sep 2022 : Case reportAcute Intermittent Porphyria: Complete Phenotype in a Patient with p.Arg173Trp Variant in Thailand
Am J Case Rep In Press; DOI: 10.12659/AJCR.937695
26 Sep 2022 : Case reportInjury to the Posterior Horn of the Lateral Meniscus from a Misplaced Tibial Tunnel for Anterior Cruciate L...
Am J Case Rep In Press; DOI: 10.12659/AJCR.937581
Most Viewed Current Articles
13 Jul 2022 : Case reportWhistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound
Am J Case Rep 2022; 23:e936441
23 Feb 2022 : Case reportPenile Necrosis Associated with Local Intravenous Injection of Cocaine
Am J Case Rep 2022; 23:e935250
06 Dec 2021 : Case reportLipedema Can Be Treated Non-Surgically: A Report of 5 Cases
Am J Case Rep 2021; 22:e934406