Rupture of papillary muscles: occurrence of rupture of the posterior muscle in posterior myocardial infarction.

Rupture of a papillary muscle of the heart has been considered an unusual complication of myocardial infarction. Although first recognized as early as 1803, only 56 cases have been reported to date. The literature was reviewed by Davison’ in 1948. He added three cases to 26 previously reported. Other instances have been described by Glendy and White; Payne and Hardy; Askey ;2 Smith, Schwartz and Canelli; Hope and Askey ;3 Craddock and Mahe ;4 Briggs; Ritama and Heino ;5 Segall and Sharp ;6 Oeser ;7 and Reuter.8 Our main purpose in presenting five more cases is to emphasize the typical combination of rupture of the posterior papillary muscle following simultaneous infarction of that muscle and of the posterior wall of the left ventricle. We should also like to note that in our experience, rupture of a papillary muscle in general has not been too rare an occurrence. We saw the five cases reported here in a relatively short period of time, and we know of an additional five cases which were not included because of insufficient clinical data.