Isolated papillary muscle rupture with nonobstructive coronary artery disease, minimal myocardial infarction, and normal wall motion.
Eleni S NakouKonstantinos C TheodoropoulosHizbullah ShaikhGeorge Amin-YoussefMark J MonaghanAlexandros PapachristidisPublished in: Echocardiography (Mount Kisco, N.Y.) (2020)
Papillary muscle (PM) rupture can usually complicate inferior or posterior myocardial infarctions, but selective PM infarction is extremely rare, and the exact underlying pathophysiological mechanism is not entirely clear. We present a case of PM rupture due to isolated PM infarction in a patient with unobstructed coronary arteries, which could be misdiagnosed as a vegetation or other mass given the absence of regional wall motion abnormalities (RWMAs) on transthoracic echocardiogram. Our case highlights that in patients with severe mitral regurgitation and associated mitral valve mass, the absence of RWMAs should not exclude ischemic PM rupture from differential diagnosis.
Keyphrases
- particulate matter
- air pollution
- coronary artery disease
- polycyclic aromatic hydrocarbons
- heavy metals
- mitral valve
- water soluble
- left ventricular
- skeletal muscle
- heart failure
- coronary artery
- climate change
- percutaneous coronary intervention
- mass spectrometry
- left atrial
- early onset
- acute coronary syndrome
- cardiovascular events
- ischemia reperfusion injury
- molecular dynamics
- coronary artery bypass grafting
- high speed
- brain injury
- hypertrophic cardiomyopathy
- transcatheter aortic valve replacement
- aortic stenosis