Complete rupture of the anterolateral papillary muscle caused by coronary spasm.
Papillary muscle rupture usually occurs as a catastrophic complication of acute myocardial infarction in patients with coronary artery stenosis; it is therefore less common in patients without coronary artery stenosis. We report the case of a 67-year old woman without coronary artery stenosis who suffered an acute anterolateral papillary muscle rupture and was successfully treated with mitral valve replacement. Evidence of coronary spasm was found on a coronary vasomotion test, suggesting that a high sensitivity to coronary spasm may explain a mechanism of isolated papillary muscle infarction.
Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan m-yamazaki@mva.biglobe.ne.jp.
Masataka
M
Yamazaki
Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan.
Toshihiro
T
Fukui
Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
Keitaro
K
Mahara
Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan.
Shuichiro
S
Takanashi
D000368:Aged; D003329:Coronary Vasospasm / Q000150:complications* / Q000000981:diagnostic imaging; D017548:Echocardiography, Transesophageal; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D010210:Papillary Muscles / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D012421:Rupture
Acute mitral regurgitation; Anterolateral papillary muscle rupture; Coronary spasm; Mitral valve replacement