Papillary Muscle Rupture after Acute Myocardial Infarction

Mitral regurgitation (MR) after myocardial infarction is a relatively common complication and its incidence is about 50%. One cause of MR after myocardial infarction is papillary muscle rupture, and this situation usually requires urgent surgical treatment. Since prognosis is favorable with early surgical intervention, early diagnosis of the underlying cause of mitral regurgitation is very important. Transthoracic echocardiography is an excellent tool for detection and estimation of the severity of mitral regurgitation in patients with myocardial infarction, especially those who have a systolic murmur. But transthoracic echocardiography may have limitations for detailed exploration of the subvalvular apparatus of the mitral valve. Multiplane transesophageal echocardiography (TEE) has been used for accurate evaluation of the mechanism of mitral regurgitation in patients with acute myocardial infarction. We experienced a case of severe mitral regurgitation due to papillary muscle rupture that was confirmed only by transgastric view of TEE.