title: Cardiac pseudoaneurysm coupled with a rupture of the papillary muscle complicating myocardial infarction.
abstract: As a complication of myocardial infarction, dual rupture of the left ventricular myocardium and the papillary muscle is a rare condition. In such a case, the heart is predisposed to reduced output because of unloading of the ventricle during systole, resulting in the patient being in danger of deteriorating into a severe state or dying suddenly from cardiogenic shock. We report a rescued case of a 65-year-old woman, who had cardiogenic shock due to left ventricular pseudoaneurysm, coupled with partial rupture of the posteromedial papillary muscle three weeks after posterior myocardial infarction. Emergent left ventriculography revealed a large aneurysmal cavity and regurgitation towards the left atrium. The patient underwent emergent aneurysmectomy with mitral valve replacement.
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Harada
authors.forename: Takao
authors.initials: T
authors.lastname: Ida
authors.forename: Teruo
authors.initials: T
authors.lastname: Takano
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D001784:Blood Gas Analysis; D006348:Cardiac Surgical Procedures / Q000379:methods; D017023:Coronary Angiography; D005260:Female; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006342:Heart Rupture, Post-Infarction / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis; D010210:Papillary Muscles / Q000503:physiopathology; D018570:Risk Assessment; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000209:etiology*; D016896:Treatment Outcome