Project description:A 52-year-old man presented with acute onset of chest pain and was found to have an inferolateral ST-segment elevation myocardial infarction and acute mitral regurgitation due to papillary muscle rupture. This case describes a rare, potentially fatal mechanical complication of acute myocardial infarction. (Level of Difficulty: Beginner.).

| S-EPMC8304571 | biostudies-literature

Anterolateral Papillary Muscle Rupture in a 78-Year-Old Man.

Project description: Not available

| S-EPMC8108710 | biostudies-literature

A rare complication of myocardial infarction.

Project description: Not available

| S-EPMC4832625 | biostudies-literature

Acute papillary muscle rupture immediately after ST-segment elevation acute myocardial infarction: A case report.

Project description:A 73-year-old woman in cardiogenic shock was referred to our hospital because of papillary muscle rupture immediately after the onset of acute myocardial infarction (MI). She had undergone emergent percutaneous coronary intervention and mitral valve replacement. Serial creatine kinase and creatine kinase MB levels indicated that she had acute phase MI on arrival. Pathological findings showed coagulative necrosis of the papillary muscle, which was characteristic evidence of the consequence of prolonged ischemia. We describe herein an unusual case of complete rupture of the posterior papillary muscle occurring immediately after the development of MI. <Learning objective: Mechanical complications of acute myocardial infarction (AMI) such as left ventricular free wall rupture, interventricular wall rupture, and papillary muscle rupture (PMR) commonly occur 2 to 7 days after the onset of AMI. We describe a case of PMR immediately after AMI, which may cause a silent and severe ischemic event a few days before the onset of PMR. This is a rare case of PMR immediately after AMI.>.

| S-EPMC6306573 | biostudies-literature

Transcatheter Mitral Valve Repair to Treat Postmyocardial Infarction Papillary Muscle Rupture.

Project description:A 75-year-old man was admitted to the emergency department for a late-presenting myocardial infarction. The coronary angiography revealed a thrombotic occlusion of the circumflex artery. He presented a rapid hemodynamic and respiratory deterioration as a result of a severe mitral regurgitation with a flail anterior leaflet due to a partial tear of the medial papillary muscle (PM). Given the patient's comorbidities, a percutaneous mitral valve repair with two-dimensional (2D)/3D transesophageal echocardiography was performed, deploying two MitraClips. MitraClip implantation may be considered in an acute setting of PM tear as an alternative for surgical treatment in selected patients.

| S-EPMC8388319 | biostudies-literature

Double ventricular rupture after acute myocardial infarction: A rare case report.

Project description:A previously asymptomatic 53-year-old male presented 5 days after an acute anterior wall myocardial infarction, who was fibrinolytic naïve, with worsening dyspnea. Transthoracic echocardiographic evaluation revealed rupture of the interventricular septum and pseudoaneurysm of the left ventricle, confirmed by angiography. Coronary angiogram revealed multivessel disease. The patient underwent successful closure of ventricular septal rupture with repair of pseudoaneurysm and saphenous vein grafts to posterior descending branch of right coronary artery and obtuse marginal branch of left circumflex artery. Double ventricular ruptures following acute myocardial infarction are very rare with a reported incidence of 0.3% from various series in the revascularization era. They are also associated with exceedingly high mortality rates reaching up to 50%, even when intervened emergently.

| S-EPMC4798976 | biostudies-literature

Prompt diagnosis of ST-elevation myocardial infarction with papillary muscle rupture by point-of-care ultrasound in the emergency department.

Project description:A previously healthy 61-year-old man presented to the emergency department with chest pain and dyspnoea for 6 hours. Examination revealed distress with an apical pansystolic murmur. Initial electrocardiogram showed sinus tachycardia and ST elevation in leads II, III, and aVF compatible with an inferior ST-elevation myocardial infarction. Point-of-care echocardiography in the emergency department showed a flail anterior mitral leaflet and severe mitral regurgitation, leading to a provisional diagnosis of papillary muscle rupture. Emergency cardiac catheterization showed 100%, 80%, and 70% occlusion of the middle right coronary, left anterior descending, and left circumflex arteries, respectively. An emergency triple vessel coronary artery bypass grafting and mitral valve replacement was performed. Posteromedial papillary muscle rupture resulting in mitral regurgitation was confirmed intraoperatively. The patient recovered uneventfully. In the absence of primary percutaneous coronary intervention, thrombolysis decisions should be made with extreme caution if mechanical complications of ST-elevation myocardial infarction are suspected.

| S-EPMC5635454 | biostudies-literature

Anterior Papillary Muscle Rupture due to Acute Myocardial Microinfarction of the Small High Lateral Branch.

Project description:Papillary muscle rupture is a catastrophic condition, of which most cases manifest posterior papillary muscle rupture. Anterior papillary muscle rupture is a rare condition. Particularly, anterior papillary muscle rupture due to acute myocardial microinfarction of the small high lateral branch is extremely rare. Since papillary muscle rupture can occur even in such a small branch or small area due to myocardial infarction, echocardiographic and/or ventriculographic confirmation is essential in cases of sudden worsening of heart failure. Herein, we report the case of anterior papillary muscle rupture with a good outcome. A 61-year-old man was admitted to our hospital with cardiogenic shock. Echocardiography revealed severe mitral regurgitation due to papillary muscle rupture. Coronary angiography demonstrated high-grade stenosis in the high lateral branch. However, no other significant stenoses were found. Emergency mitral valve replacement was performed. The patient was discharged 19 days after surgery without any complications.

| S-EPMC9286937 | biostudies-literature

Intramyocardial dissecting haematoma mimicking left ventricular clot, a rare complication of myocardial infarction: a case report.

Project description:Intramyocardial dissecting haematoma is a rare complication of myocardial infarction (MI) associated with high mortality rates. Studies and research of this occurrence are limited largely to isolated case reports or case series. We report a case of late presenting MI, where on initial echocardiogram had what was thought to be an intraventricular clot. However, upon further evaluation, the patient actually had an intramyocardial haematoma, with the supporting echocardiographic features to distinguish it from typical left ventricular (LV) clot. While this prevented the patient from receiving otherwise unnecessary anticoagulation, this diagnosis also put him at a much higher risk of mortality. Despite exhaustive medical and supportive management, death as consequence of pump failure occurred after 2 weeks. This report highlights the features seen on echocardiography which support the diagnosis of an intramyocardial haematoma rather than an LV clot, notably the various acoustic densities, a well visualized myocardial dissecting tear leading into a neocavity filled with blood, and an independent endocardial layer seen above the haematoma. Based on this report, we wish to highlight the importance of differentiating intramyocardial haematomas from intraventricular clots in patients with recent MI.

| S-EPMC6601172 | biostudies-literature

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