Acute partial papillary muscle rupture as a rare complication following non-ST elevation myocardial infarction

Area of Science:

• Cardiology
• Cardiac Surgery
• Pathology

Background:

• Papillary muscle rupture is a severe complication of acute myocardial infarction (MI).
• It typically manifests 2-7 days post-MI, often leading to acute mitral regurgitation.
• Prompt diagnosis and surgical management are critical due to high mortality rates.

Observation:

• A rare case of acute partial anterolateral papillary muscle rupture is presented.
• The rupture occurred following a non-ST elevation myocardial infarction (NSTEMI).
• The patient, an elderly male, presented with a detached anterolateral papillary muscle.

Findings:

• The patient required emergent mitral valve replacement due to the papillary muscle rupture.
• Anterolateral papillary muscle rupture is an uncommon presentation of this complication.
• Delayed treatment significantly increases mortality risk.

Implications:

• This case highlights the importance of considering papillary muscle rupture in MI patients, even with atypical presentations like NSTEMI.
• Urgent cardiothoracic surgical referral is paramount for patients diagnosed with papillary muscle rupture.
• Survival rates are drastically improved with timely surgical intervention, contrasting with the >90% mortality within a week without surgery.