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[Traumatic papillary muscle rupture--a case report].

A Kawai¹, S Saito, A Takazawa

¹Department of Cardiovascular Surgery, Tokyo Women's Medical College, Japan.

[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai

|October 1, 1991

Summary

A young man developed respiratory distress after a chest injury, initially diagnosed as respiratory distress syndrome. Echocardiography revealed papillary muscle rupture causing mitral valve prolapse, successfully treated with valve replacement.

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Area of Science:

Cardiology
Thoracic Surgery
Critical Care Medicine

Background:

Chest trauma can lead to complex cardiac complications.
Early diagnosis of cardiac injury post-trauma is crucial for patient outcomes.

Observation:

A previously healthy young male presented with progressive respiratory deterioration and pulmonary venous congestion post-chest injury.
Despite positive pressure ventilation, the patient remained in New York Heart Association (NYHA) class IV heart failure.
Trans-esophageal echocardiography identified anterior mitral leaflet prolapse secondary to papillary muscle rupture.

Findings:

Papillary muscle rupture is a rare but severe complication of chest trauma.
Mitral valve prolapse due to papillary muscle rupture can cause acute, severe heart failure.

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Successful mitral valve replacement resolved the patient's critical condition.

Implications:

This case highlights the importance of considering cardiac complications in patients with chest trauma and respiratory distress.
Prompt echocardiographic evaluation is essential for diagnosing mechanical cardiac complications.
Surgical intervention, such as mitral valve replacement, can be life-saving in these critical cases.