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Vol 17, No 4 (2010)
Case Reports
Submitted: 2013-01-14
Published online: 2010-07-27
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Massive mitral regurgitation secondary to acute ischemic papillary muscle rupture: The role of echocardiography

Stefano Lunghetti, Maria Grazia D’Asaro, Giuseppe Guerrieri, Valerio Zacà, Arcangelo Carrera, Sandra Fusi, Margherita Padeletti, Sergio Mondillo, Roberto Favilli
Cardiol J 2010;17(4):397-400.

open access

Vol 17, No 4 (2010)
Case Reports
Submitted: 2013-01-14
Published online: 2010-07-27

Abstract

Papillary muscle rupture is an infrequent but often fatal mechanical complication of acute myocardial infarction (AMI). We report the case of an AMI complicated by the development of an abrupt cardiogenic shock due to the rupture of the head of the postero-medial papillary muscle with echocardiographic demonstration of severe mitral regurgitation due to flail posterior mitral valve leaflet. After initial stabilization with medical therapy and diagnostic coronary angiography, the patient was referred for urgent cardiac surgery and successfully underwent mitral valve replacement with implantation of a bioprosthesis. This case confirms the importance of transthoracic echocardiography in diagnosing mechanical acute complications during an AMI and in the decision making of patients with sudden onset of hemodynamic compromise. Transthoracic echogardiography should be immediately carried out in all patients in whom a mechanical complication during an AMI is suspected.
(Cardiol J 2010; 17, 4: 397-400)

Abstract

Papillary muscle rupture is an infrequent but often fatal mechanical complication of acute myocardial infarction (AMI). We report the case of an AMI complicated by the development of an abrupt cardiogenic shock due to the rupture of the head of the postero-medial papillary muscle with echocardiographic demonstration of severe mitral regurgitation due to flail posterior mitral valve leaflet. After initial stabilization with medical therapy and diagnostic coronary angiography, the patient was referred for urgent cardiac surgery and successfully underwent mitral valve replacement with implantation of a bioprosthesis. This case confirms the importance of transthoracic echocardiography in diagnosing mechanical acute complications during an AMI and in the decision making of patients with sudden onset of hemodynamic compromise. Transthoracic echogardiography should be immediately carried out in all patients in whom a mechanical complication during an AMI is suspected.
(Cardiol J 2010; 17, 4: 397-400)

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Keywords

echocardiography; papillary muscle; rupture

About this article
Title

Massive mitral regurgitation secondary to acute ischemic papillary muscle rupture: The role of echocardiography

Journal

Cardiology Journal

Issue

Vol 17, No 4 (2010)

Pages

397-400

Published online

2010-07-27

Page views

773

Article views/downloads

1574

Bibliographic record

Cardiol J 2010;17(4):397-400.

Keywords

echocardiography
papillary muscle
rupture

Authors

Stefano Lunghetti
Maria Grazia D’Asaro
Giuseppe Guerrieri
Valerio Zacà
Arcangelo Carrera
Sandra Fusi
Margherita Padeletti
Sergio Mondillo
Roberto Favilli

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