Related Experiment Videos
Comparison of patients with and without papillary muscle rupture during acute myocardial infarction
J Figueras1, F Calvo, J Cortadellas
1Unitat Coronària, Servei de Cardiologia, Hospital General Vall d'Hebron, Barcelona, Spain.
Abstract:
Seventeen of 31 patients with papillary muscle rupture (PMR) were admitted with a >24-hour delay since onset of acute myocardial infarction (AMI) in contrast to 81 of 1,012 with AMI without cardiac rupture; in 8 of 11 patients with in-hospital PMR it was preceded by new anginal pain in 5 and/or by strenuous exercise in 4; mortality was higher in those with anterior PMR, previous infarction, or 3-vessel disease than in those without PMR. Thus, persistence of physical activity before or during hospitalization, as well as postinfarction ischemia/infarct extension, appear to be relevant triggers of PMR, whereas mortality is more often associated with existence of a previous infarction, 3-vessel disease, and/or anterior PMR.
Insights
Papillary muscle rupture (PMR) often occurs after a delayed admission for acute myocardial infarction (AMI). Physical activity and post-infarction ischemia may trigger PMR, while anterior PMR and prior heart conditions increase mortality risk.
Area of Science:
- Cardiology
- Clinical Medicine
Background:
- Papillary muscle rupture (PMR) is a rare but severe complication of acute myocardial infarction (AMI).
- Understanding PMR triggers and associated mortality factors is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the time of admission relative to AMI onset in patients with PMR.
- To identify potential triggers of in-hospital PMR.
- To determine factors associated with increased mortality in PMR patients.
Main Methods:
- Retrospective analysis of patients with AMI, comparing those with and without PMR.
- Analysis of clinical data, including time to admission, presence of new anginal pain, strenuous exercise, and pre-existing cardiovascular conditions.
Main Results:
- A significant delay (>24 hours) in admission for AMI was observed in 17 of 31 PMR patients compared to 81 of 1,012 non-PMR patients.
- In-hospital PMR was preceded by new anginal pain or strenuous exercise in a majority of affected patients.
- Anterior PMR, previous infarction, and 3-vessel disease were associated with higher mortality.
Conclusions:
- Delayed admission for AMI, persistence of physical activity, and post-infarction ischemia/infarct extension may act as triggers for PMR.
- Mortality in PMR patients is significantly associated with anterior PMR, prior infarction history, and 3-vessel disease.