Ischemic rupture of the anterolateral papillary muscle.
نویسندگان
چکیده
We describe the case of a 59-year-old man who presented with chest pain and ST-segment elevation in the inferior leads, R>S in V1 and ST depression in the anterior leads due to proximal occlusion of the first obtuse marginal. Primary coronary angioplasty and stenting of this artery were performed. Twelve hours later the patient became hemodynamically unstable and severe mitral regurgitation due to rupture of one of the heads of the anterolateral papillary muscle was diagnosed. Emergency surgery was performed (papillary muscle head reimplantation, mitral annuloplasty with a rigid ring, tricuspid annuloplasty and coronary artery bypass grafting). On surgical inspection, it was observed that the detached muscle head had become trapped in the left ventricle by a secondary cord attached to the other head. This case is unusual in presenting two uncommon features of ischemic papillary muscle: rupture of the anterolateral muscle in myocardial infarction involving the inferoposterior walls, and the fact that the ruptured muscle head did not prolapse because it had become trapped in the left ventricle by secondary cord attachment.
منابع مشابه
Isolated right coronary lesion and anterolateral papillary muscle rupture - case report and review of the literature
Ischemic rupture of the anterolateral papillary muscle is uncommon due to its dual blood supply. It usually follows an ischemic event involving branches of the left circumflex or left anterior descending arteries. We present a case of a patient admitted with an acute inferior wall myocardial infarction and an isolated distal right coronary artery occlusion. Acute mitral regurgitation with ruptu...
متن کاملیک مورد نادر پارگی سر عضله پاپیلاری قدامی طرفی بدون انفارکتوس حاد میوکارد و یا بیماری عروق کرونری
A rare complication of AMI is papillary muscle rupture (PMR), occurring in 1% of patients with acute myocardial infarction (AMI). Mitral regurgitation related to PMR occurs at a median of 1 day (ranging from 1-14 days) after onset of myocardial infarction. PMR tends to occur in those having a first time AMI and those without extensive collateral circulation. PMR involves posteromedial papillary...
متن کاملAnterolateral papillary muscle rupture caused by myocardial infarction: A case report
BACKGROUND The rupture of the anterolateral papillary muscle is less common than the posteromedial papillary muscle since the anterolateral muscle has dual blood supplies, while the posteromedial papillary muscle has a single blood supply. CASE PRESENTATION We present a case report of a 42 year old male presenting with heart failure being diagnosed to have mitral regurgitation from the partia...
متن کاملComplete rupture of the anterolateral papillary muscle caused by coronary spasm.
Papillary muscle rupture usually occurs as a catastrophic complication of acute myocardial infarction in patients with coronary artery stenosis; it is therefore less common in patients without coronary artery stenosis. We report the case of a 67-year old woman without coronary artery stenosis who suffered an acute anterolateral papillary muscle rupture and was successfully treated with mitral v...
متن کاملSurgical treatment of complete anterolateral papillary muscle rupture following acute myocardial infarction.
Papillary muscle rupture is a lethal complication of after acute myocardial infarction. We report the successful surgical management of complete anterolateral papillary muscle rupture associated with cardiogenic shock in an 80-year-old woman. The patient was admitted with the sudden onset of chest pain and dyspnea. After hemodynamics deteriorated rapidly, she was intubated and intra-aortic ball...
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عنوان ژورنال:
- Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology
دوره 32 3 شماره
صفحات -
تاریخ انتشار 2013