Case report and review of nonischemic spontaneous papillary muscle rupture reports between 2000 and 2015

Abstract

Spontaneous papillary muscle rupture (PMR) is a rare cardiovascular emergency. We present a 63-year-old male who presents with acute dyspnea who was found to have an anterior PMR, with no evidence of coronary artery disease, infection, or trauma. A review of cases of nonischemic spontaneous PMR published in 2000-2015 identified 11 additional cases of spontaneous PMR. Posterior and anterior papillary muscles involvement was identified in 54.5% and 45.5% of cases, respectively. Rapid identification due to advances in imaging modalities and improved surgical management has led to optimal outcomes in patients with spontaneous PMR.

A Non-ischemic Spontaneous Papillary Muscle Rupture. Case Report

“…Gouda et al published a review of all non-ischemic spontaneous PMR case reports up to 2015 (2), differential etiologies noted in the summary include myocarditis (5,6), endocarditis and fungal infections (7,8), Ehler Danlos type IV, Takotsubo cardiomyopathy and mitral annular calcification are other described entities (3,4,9,10). From the 12 cases published thus far, 4 of them had an unknown etiology (2,11,12,13).…”

“…Papillary muscle rupture (PMR) is one of the most serious mechanical complications of acute myocardial infarction, with an incidence of 0.5-5% (1). Some reports of PMR not related with ischemic failure include idiopathic, infectious or connective tissue disorder etiologies (2), including Takotsubo disease (3,4). In this paper, we present a case of non-ischemic spontaneous PMR, potentially related with extreme physical activity.…”

Individual variability of vascularization of the anterior papillary muscle within the right ventricle of human heart

“…Ischemia of papillary muscles can result in clinical dysfunction and a valvular prolapse syndrome [ 30 ]. In severe cases ischemia can lead to rupture of the papillary muscle, which without a surgical intervention may be lethal [ 9 , 11 , 31 , 32 ].…”

Anterolateral papillary muscle rupture as a rare complication of unusual infective endocarditis

“…The IE lesions consist on vegetations and valvular destruction that are located essentially on the valves. The rupture of the mitral papillary muscle due to IE is a very rare complication (2,3). We report here the case of severe mitral regurgitation occurring on normal mitral valve with anterolateral papillary muscle rupture due to IE.…”