Diagnostic Pitfalls in Papillary Muscle Rupture-Associated Acute Mitral Regurgitation after Acute Myocardial Infarction

Papillary muscle rupture (PMR) is a rare and fatal complication of acute myocardial infarction (AMI). We report a case of acute mitral regurgitation (MR) due to PMR with pulmonary edema and cardiogenic shock following AMI with small myocardial necrosis. An 88-year-old woman was brought to our emerge...

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Main Authors: Akiko Kameyama, Hiroshi Imamura, Hiroshi Kamijo, Kanako Takeshige, Katsunori Mochizuki, Kenichi Nitta
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2021/1396194
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author Akiko Kameyama
Hiroshi Imamura
Hiroshi Kamijo
Kanako Takeshige
Katsunori Mochizuki
Kenichi Nitta
author_facet Akiko Kameyama
Hiroshi Imamura
Hiroshi Kamijo
Kanako Takeshige
Katsunori Mochizuki
Kenichi Nitta
author_sort Akiko Kameyama
collection DOAJ
description Papillary muscle rupture (PMR) is a rare and fatal complication of acute myocardial infarction (AMI). We report a case of acute mitral regurgitation (MR) due to PMR with pulmonary edema and cardiogenic shock following AMI with small myocardial necrosis. An 88-year-old woman was brought to our emergency department in acute respiratory distress, shock, and coma. She had no systolic murmur, and transthoracic echocardiography was inconclusive. Coronary angiography showed obstruction of the posterior descending branch of the right coronary artery. Although the infarction was small, the hemodynamics did not improve. Transesophageal echocardiography established papillary muscle rupture with severe mitral regurgitation 5 days after admission. Thereafter, the patient and her family did not consent to heart surgery, and she eventually died of progressive heart failure. Physicians should be aware of papillary muscle rupture with acute mitral regurgitation following AMI in patients with unstable hemodynamics, no systolic murmur, and no abnormalities revealed on transthoracic echocardiography.
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series Case Reports in Critical Care
spelling doaj-art-285dcb5be1314af09d7d3b95627f87d82025-08-20T03:54:42ZengWileyCase Reports in Critical Care2090-64392021-01-01202110.1155/2021/1396194Diagnostic Pitfalls in Papillary Muscle Rupture-Associated Acute Mitral Regurgitation after Acute Myocardial InfarctionAkiko Kameyama0Hiroshi Imamura1Hiroshi Kamijo2Kanako Takeshige3Katsunori Mochizuki4Kenichi Nitta5Department of Emergency and Critical Care MedicineDepartment of Emergency and Critical Care MedicineDepartment of Emergency and Critical Care MedicineDepartment of Emergency and Critical Care MedicineDepartment of Emergency and Critical Care MedicineDepartment of Emergency and Critical Care MedicinePapillary muscle rupture (PMR) is a rare and fatal complication of acute myocardial infarction (AMI). We report a case of acute mitral regurgitation (MR) due to PMR with pulmonary edema and cardiogenic shock following AMI with small myocardial necrosis. An 88-year-old woman was brought to our emergency department in acute respiratory distress, shock, and coma. She had no systolic murmur, and transthoracic echocardiography was inconclusive. Coronary angiography showed obstruction of the posterior descending branch of the right coronary artery. Although the infarction was small, the hemodynamics did not improve. Transesophageal echocardiography established papillary muscle rupture with severe mitral regurgitation 5 days after admission. Thereafter, the patient and her family did not consent to heart surgery, and she eventually died of progressive heart failure. Physicians should be aware of papillary muscle rupture with acute mitral regurgitation following AMI in patients with unstable hemodynamics, no systolic murmur, and no abnormalities revealed on transthoracic echocardiography.http://dx.doi.org/10.1155/2021/1396194
spellingShingle Akiko Kameyama
Hiroshi Imamura
Hiroshi Kamijo
Kanako Takeshige
Katsunori Mochizuki
Kenichi Nitta
Diagnostic Pitfalls in Papillary Muscle Rupture-Associated Acute Mitral Regurgitation after Acute Myocardial Infarction
Case Reports in Critical Care
title Diagnostic Pitfalls in Papillary Muscle Rupture-Associated Acute Mitral Regurgitation after Acute Myocardial Infarction
title_full Diagnostic Pitfalls in Papillary Muscle Rupture-Associated Acute Mitral Regurgitation after Acute Myocardial Infarction
title_fullStr Diagnostic Pitfalls in Papillary Muscle Rupture-Associated Acute Mitral Regurgitation after Acute Myocardial Infarction
title_full_unstemmed Diagnostic Pitfalls in Papillary Muscle Rupture-Associated Acute Mitral Regurgitation after Acute Myocardial Infarction
title_short Diagnostic Pitfalls in Papillary Muscle Rupture-Associated Acute Mitral Regurgitation after Acute Myocardial Infarction
title_sort diagnostic pitfalls in papillary muscle rupture associated acute mitral regurgitation after acute myocardial infarction
url http://dx.doi.org/10.1155/2021/1396194
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