title: Papillary muscle injury after blunt chest trauma.
abstract: In many cases blunt chest trauma involves cardiac lesions, such as pericardial effusion, aneurysma dissecans, or valvular rupture. Early diagnosis with routine transthoracic and/or transesophageal echocardiography is essential to prevent a fatal outcome. In the case reported, a previously healthy 68-year-old woman fell 7 meters from the roof of a barn and sustained blunt injury to the chest as well as fractures of the face. Physical examination revealed a systolic murmur at the cardiac apex, and chest x-ray film showed a severe pulmonary edema. Transesophageal echocardiography demonstrated a ruptured anterolateral papillary muscle with fourth degree mitral insufficiency. An immediate mitral valve replacement was necessary.
authors.affiliation: Zentrum für Innere Medizin, Abteilung Kardiologie, Klinikum der Philipps-Universität, Marburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Wilke
authors.forename: T
authors.initials: T
authors.lastname: Kruse
authors.forename: H
authors.initials: H
authors.lastname: Hesse
authors.forename: A
authors.initials: A
authors.lastname: Bittinger
authors.forename: R
authors.initials: R
authors.lastname: Moosdorf
authors.forename: B
authors.initials: B
authors.lastname: Maisch
mesh_terms: D000058:Accidental Falls; D000368:Aged; D017548:Echocardiography, Transesophageal; D005151:Facial Injuries / Q000150:complications; D005260:Female; D006335:Heart Injuries / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000209:etiology; D010210:Papillary Muscles / Q000293:injuries*; D011654:Pulmonary Edema / Q000209:etiology; D012421:Rupture; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery