Atypical Presentation of Acute Mitral Regurgitation Secondary to Papillary Muscle Rupture

Kushal H Porwal; Mokshal H Porwal; Mohammed M Ibrahim; Hariharan Ramaswamykanive; Krishan Gupta; Manu Mathur; Seshasayee Narasimhan

doi:10.7759/cureus.24744

Atypical Presentation of Acute Mitral Regurgitation Secondary to Papillary Muscle Rupture

Cureus. 2022 May 5;14(5):e24744. doi: 10.7759/cureus.24744. eCollection 2022 May.

Authors

Kushal H Porwal¹, Mokshal H Porwal², Mohammed M Ibrahim³, Hariharan Ramaswamykanive³, Krishan Gupta¹, Manu Mathur⁴, Seshasayee Narasimhan^{5

6

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Affiliations

¹ Internal Medicine, Manning Base Hospital, Taree, AUS.
² Cardiology, Medical College of Wisconsin, Wauwatosa, USA.
³ Intensive Care Medicine, Manning Base Hospital, Taree, AUS.
⁴ Cardiothoracic Surgery, Royal North Shore Hospital, Sydney, AUS.
⁵ Cardiology, Internal Medicine, Manning Base Hospital, Taree, AUS.
⁶ Conjoint Senior, University of Newcastle, Callaghan, AUS.
⁷ Adjunct Senior Lecturer, University of New England, Armidale, AUS.

Abstract

Acute mitral regurgitation (MR) is a life-threatening condition presenting with severe decompensated heart failure due to sudden retrograde blood flow into the left atrium. The causes are broadly classified into ischemic and non-ischemic. Rapid and accurate diagnosis of acute MR and its potential causes is essential. This case uniquely highlights an atypical presentation of severe MR secondary to papillary muscle rupture without a known, identifiable cause. Therefore, suspicion of acute MR should be high if clinical symptoms are present, even without known risk factors, due to the high morbidity and mortality associated with delayed management.

Keywords: acute mitral regurgitation; cardiogenic shock; flail mitral leaflet; mitral regurgitation; papillary muscle rupture.

Publication types

Case Reports