The echocardiographic diagnosis of rupture of a papillary muscle

The echocardiographic diagnosis of acute rupture of a papillary muscle is described. The pertinent findings included (1) decreased systolic motion of the posterior wall, (2) exaggerated septal motion, (3) left ventricular enlargement and pattern suggesting left ventricular diastolic overload, and (4) bizarre fluttering of posterior leaflet of the mitral valve in diastole, suggesting an unhinging of the mitral valvular apparatus. The echocardiogram is a useful noninvasive tool in the diagnosis of this often fatal complication of myocardial infarction.