title: Real time three-dimensional transesophageal echocardiography in partial posteromedial papillary muscle rupture.
abstract: A 60-year-old hypertensive male with non-ST segment elevation myocardial infarction had a hyperdynamic LV with mild posterior leaflet mitral valve prolapse without significant regurgitation on transthoracic echocardiogram. Two-dimensional (2D) TEE showed severe mitral regurgitation with prolapse of P2 and P3 scallops. Posteromedial papillary muscle rupture was suspected. Three-dimensional (3D) TEE demonstrated severely prolapsing P2 and P3 valve scallops with a clear view of the partially ruptured posteromedial papillary muscle. Patient underwent emergency coronary bypass and mitral valve replacement. Surgical pathology of papillary muscle confirmed coagulative necrosis. 3D TEE was superior in identifying the partial posteromedial papillary muscle rupture.
authors.affiliation: Division of Cardiology, University of Texas Medical Branch, Galveston, Texas, USA.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Havins
authors.forename: Scott
authors.initials: S
authors.lastname: Lick
authors.forename: Paul
authors.initials: P
authors.lastname: Boor
authors.forename: Harvinder
authors.initials: H
authors.lastname: Arora
authors.forename: Masood
authors.initials: M
authors.lastname: Ahmad
mesh_terms: D003199:Computer Systems; D003937:Diagnosis, Differential; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods; D006342:Heart Rupture, Post-Infarction / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D010210:Papillary Muscles / Q000000981:diagnostic imaging* / Q000293:injuries*; D016896:Treatment Outcome
keywords: acute myocardial infarction; mitral regurgitation; papillary muscles; three-dimensional transesophageal echocardiography