Papillary muscle rupture following acute myocardial infarction: Anatomic, echocardiographic, and surgical insights

Echocardiography. 2017 Nov;34(11):1702-1707. doi: 10.1111/echo.13739. Epub 2017 Oct 29.

Abstract

Papillary muscle (PM) rupture is a rare complication of acute myocardial infarction which carries an excessive mortality rate. Optimal outcomes require rapid diagnosis and prompt surgical referral, and in this regard, echocardiography plays a crucial role. Comprehensive echocardiographic examination of the patient with PM rupture consists of identification of the ruptured PM segment, visualization of flail mitral valve segment(s), evaluation of mitral regurgitation severity, and assessment of left ventricular systolic function. This article discusses anatomic and echocardiographic features as well as the surgical management of PM rupture.

Keywords: acute mitral regurgitation; echocardiography; flail mitral valve; mitral valve commissures; myocardial infarction; papillary muscle rupture.

Publication types

  • Case Reports

MeSH terms

  • Echocardiography / methods*
  • Heart Rupture, Post-Infarction / diagnostic imaging*
  • Heart Rupture, Post-Infarction / surgery*
  • Heart Valve Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Papillary Muscles / anatomy & histology
  • Papillary Muscles / diagnostic imaging*
  • Papillary Muscles / surgery*
  • Reoperation
  • Treatment Outcome