title: A Case of Post Myocardial Infarction Papillary Muscle Rupture.
abstract: Papillary muscle rupture is a rare, life-threatening post myocardial infarction mechanical complication. Without surgical intervention, prognosis is very poor. Clinicians need to recognize this complication early, as prompt therapy is crucial. We present a case of inferior ST elevation myocardial infarction complicated by posteromedial papillary muscle rupture resulting in severe acute mitral regurgitation (flail anterior mitral leaflet), acute pulmonary edema and cardiogenic shock. In our patient, a new mitral regurgitation murmur suggested this mechanical complication. Complete disruption of papillary muscle was visualized by transesophageal echocardiography. This case illustrates the importance of good physical examination for early diagnosis of papillary muscle rupture, so that life-saving treatment can be administered without delay.
authors.forename: Amornpol
authors.initials: A
authors.lastname: Anuwatworn
authors.forename: Christopher
authors.initials: C
authors.lastname: Milnes
authors.forename: Vishesh
authors.initials: V
authors.lastname: Kumar
authors.forename: Amol
authors.initials: A
authors.lastname: Raizada
authors.forename: Verlyn
authors.initials: V
authors.lastname: Nykamp
authors.forename: Adam
authors.initials: A
authors.lastname: Stys
mesh_terms: D000368:Aged; D001705:Bioprosthesis; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000379:methods*; D042241:Early Diagnosis; D017548:Echocardiography, Transesophageal / Q000379:methods; D006342:Heart Rupture, Post-Infarction / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D010210:Papillary Muscles / Q000000981:diagnostic imaging / Q000293:injuries; D010808:Physical Examination / Q000379:methods; D012720:Severity of Illness Index; D016896:Treatment Outcome