[Complete Anterior Papillary Muscle Rupture with Angiographically Normal Coronary Arteries;Report of a Case]
Masaaki Sugawara1, Hiroyuki Hirahara, Maya Watanabe
1Department of Cardiovascular Surgery, Japanese Red Cross Nagaoka Hospital, Nagaoka, Japan.
Abstract:
We present a case of complete anterior papillary muscle rupture (PMR) due to localized papillary muscle infarction, without significant coronary artery disease. A 69-year-old woman was transferred to our hospital because of acute orthopnea and cardiogenic shock. Echocardiography showed severe mitral regurgitation due to anterior PMR, and emergency coronary angiography revealed no obstructive disease in the coronary arteries. Emergency mitral valve replacement was performed with intra-aortic balloon pumping support. Intraoperatively, the anterolateral papillary muscle was found to be completely ruptured. With maximal posterior leaflet preservation, mitral valve replacement was successfully performed. Her postoperative course was uneventful. Pathologic examination showed both old fibrosis and new ischemic lesion in the same resected papillary muscle. It could be speculated that repeated localized subendocardial infarction caused so-called spontaneous PMR.
More Related Videos
Related Concept Videos
Coronary Artery Disease II: Pathophysiology
Acute Coronary Syndrome I: Introduction
Acute Coronary Syndrome III: Diagnostic Studies
Aneurysm I: Introduction
Aneurysm II: Clinical Manifestations and Diagnostic Studies


