title: Bigeminy and the bifid papillary muscle.
abstract: Various structural anomalies of the left ventricular papillary muscles have been observed in recent years. Many of these have been linked to electrocardiographic aberrations. Recently two reports have appeared where the base of the posterior papillary muscle was identified as the source of frequent premature ventricular complexes. In some of these patients these frequent premature ventricular complexes have led to left ventricular dysfunction. In this report a newly discovered structural variant of the anterior papillary muscle is described--the bifid papillary muscle. Furthermore, it is proposed that this bifid papillary muscle is the source of frequent ventricular premature complexes, presenting as bigeminy in a patient with normal left ventricular function.
authors.affiliation: Department of Physiology, University of Pretoria, Pretoria, South Africa. jker@wol.co.za
authors.forename: James
authors.initials: J
authors.lastname: Ker
mesh_terms: D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D010210:Papillary Muscles / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left; D018879:Ventricular Premature Complexes / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology
references.citation: Int J Cardiol. 2010 Jun 25;142(1):e1-2
references.pmid: 19157596
references.citation: Cardiovasc J Afr. 2009 Jul-Aug;20(4):256-7
references.pmid: 19701539
references.citation: Ann Intern Med. 1992 Nov 1;117(9):766-70
references.pmid: 1384411
references.citation: J Am Soc Echocardiogr. 2006 Jul;19(7):939.e9-11
references.pmid: 16825011
references.citation: Cardiovasc Ultrasound. 2009 Oct 29;7:50
references.pmid: 19874622
references.citation: J Interv Card Electrophysiol. 2009 Jun;25(1):67-72
references.pmid: 19148724
references.citation: Circ Arrhythm Electrophysiol. 2008 Apr;1(1):23-9
references.pmid: 19808390
references.citation: Angiology. 2007 Aug-Sep;58(4):502-3
references.pmid: 17636184