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Published on: May 19, 2020
Acute torrential mitral regurgitation secondary to iatrogenic papillary muscle rupture
Christopher Bernard Marsalisi1, Loruanma Lam2, Julien Feghaly3
1Internal Medicine, University of Florida College of Medicine, Jacksonville, Florida, USA Christopher.marsalisi@jax.ufl.edu.
Abstract:
Papillary Muscle rupture is a rare and potentially life-threatening complication that is typically observed in the days following acute myocardial infarction. Less commonly, rupture of a papillary muscle may arise as an iatrogenic complication of cardiac procedures. We present a case of cardiogenic shock in the setting of torrential mitral regurgitation secondary to iatrogenic papillary muscle rupture during a left ventricular angiogram. The patient was placed on percutaneous mechanical circulatory support with Impella CP and transferred for emergent mitral valve replacement. This case highlights the potential complications of minimally invasive cardiac procedures and reviews the management of acute severe mitral regurgitation.
Insights
Papillary muscle rupture, a rare complication of cardiac procedures, can cause severe mitral regurgitation and cardiogenic shock. Prompt intervention with mechanical support and valve replacement is crucial for patient survival.
Area of Science:
- Cardiology
- Cardiac Surgery
- Interventional Cardiology
Background:
- Papillary muscle rupture is a rare but serious complication, often linked to acute myocardial infarction.
- Iatrogenic papillary muscle rupture can occur during cardiac procedures, posing a significant risk.
Observation:
- A case of cardiogenic shock due to severe mitral regurgitation from iatrogenic papillary muscle rupture during a left ventricular angiogram is presented.
- The patient experienced torrential mitral regurgitation necessitating immediate intervention.
Findings:
- Percutaneous mechanical circulatory support with Impella CP was initiated.
- Emergent mitral valve replacement was performed following stabilization.
Implications:
- This case underscores the potential risks associated with minimally invasive cardiac procedures.
- Effective management strategies for acute severe mitral regurgitation secondary to papillary muscle rupture are reviewed.
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