Acute mitral regurgitation after non-ischemic papillary muscle rupture: A case report

Abstract

Papillary muscle rupture (PMR) is a life-threatening cardiac emergency that is generally associated with inadequate myocardial perfusion after acute myocardial infarction. Nonischemic spontaneous PMR occurs less frequently and is mostly caused by myocarditis, infections, or trauma. We report a patient with spontaneous PMR resulting in severe mitral regurgitation with refractory heart failure showing no specific causes but deterioration of the mitral leaflet and papillary muscle. The integration of pathologic and echocardiographic findings describes the details of the disease. <Learning objective: Spontaneous papillary muscle rupture is relatively rare compared with cardiac infarctions. Myocarditis, infection, and trauma are most common reasons, but long-term papillary muscle deterioration due to mechanical force can rupture without such episodes. Acute mitral regurgitation due to papillary muscle rupture is life-threatening, thus, evaluation for surgical therapy should be immediately initiated.>.

Keywords: Acute mitral valve regurgitation; Cardiogenic shock; Spontaneous papillary muscle rupture.