Solitary papillary muscle hypertrophy in young athletes

Gregorio, Cesare de; Speranza, Giampiero; Zagari, Domenico; Caruso, Rosalba

doi:10.2459/jcm.0b013e328360943e

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…Some previous case reports have described isolated papillary muscle hypertrophy . Gregorio et al . described a case in which solitary papillary muscle hypertrophy might cause inverted T‐waves on ECG in two young trained soccer players.…”

Section: Discussionmentioning

confidence: 99%

Significance of isolated papillary muscle hypertrophy: A comparison of left ventricular hypertrophy diagnosed using electrocardiography vs echocardiography

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Significance of isolated papillary muscle hypertrophy: A comparison of left ventricular hypertrophy diagnosed using electrocardiography vs echocardiography

et al. 2017

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“…Kobashi [9]and others believe that papillary muscle hypertrophy is an early form of hypertrophic cardiomyopathy. GNT can exist in single papillary muscle hypertrophy [10,11]. Papillary muscle hypertrophy is defined as at least one group of papillary muscles with a diameter [?]…”

Section: Detection Methodmentioning

confidence: 99%

Eleven patients with deformed papillary muscles and downward movement were misdiagnosed as cardiomyocyte ischemia due to giant negative T wave

Ding¹,

Guo²,

Deng³

et al. 2020

Preprint

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Objective: To analyze the clinical manifestations of a huge inverted T wave and to summarize the causes of misdiagnosis of deformed papillary muscle as myocardial ischemia. Cases and Results: A retrospective analysis of the clinical data of 215 patients with 12-lead ECG T wave inverted myocardial ischemia from 2006 to 2018 in our hospital. Combined with multi-factor logistic regression analysis of echocardiography and electrocardiogram, we evaluated 11 cases of unique clinical malformed papillary muscles with lowered position. The electrocardiogram showed sinus rhythm, the electrocardiogram axis was normal, and the T wave inversion was 6-10 mm. The angiography showed no abnormalities. The echocardiogram showed that the left ventricular wall structure, motion, and left ventricular ejection fraction were within the normal range. Echocardiography showed that the anterolateral papillary muscle base of 11 patients originated from the apex 1/3. A 12-lead ECG with deformed papillary muscles shows that a huge inverted T wave is not a feature of myocardial ischemia. In this case, the 12-lead ECG feature is insufficient to identify the cause of myocardial ischemia. Therefore, we must exclude these myocardial ischemia in order to diagnose and treat correctly. Conclusion: Conventional 12-lead electrocardiogram shows that the giant inverted T wave of the deformed papillary muscles is diagnosed as myocardial ischemia, which is a misdiagnosis.

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Papillary muscles. Dark side of the heart: A simple approach for a forgotten structure

Babio¹,

Janavel²,

Carrero³

et al. 2020

Echocardiography

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PurposeTransthoracic echocardiography (TTE) is currently the election method for initial screening of left ventricular papillary muscles (PM). However, diagnosis of borderline PM hypertrophy with TTE is not always feasible due to cumbersome interpretation of different PM diameters and the absence of precise normal ranges in the literature. The objective of this study was to obtain TTE normal cutoff values and to describe convenient indexes of PM dimensions.MethodsHealthy volunteers with normal electrocardiogram were included for TTE assessment. Vertical (Vd) and horizontal (Hd) PM diameters were measured to obtain maximum diameter (Md) and areas of the anterolateral PM (APM) and posteromedial PM (PPM) to obtain PM total area (PMTA).ResultsA total of 82 patients were screened, and 6 (7.3%) with bifid PM were excluded from analysis. APM and PPM had similar Vd (APM: 8.3 ± 1.2, PPM: 7.9 ± 1.1 mm2, P = NS) and Hd (APM: 8.2 ± 1.3, PPM: 8.3 ± 1.2 mm2, P = NS). Finally, Md (9 ± 1.2 mm; P95 = 11 mm) and PMTA (106.5 ± 24.2 mm2; P95 = 150.8 mm2) were obtained. Correlation between PMTA and Md was positive (P < .001), and out‐of‐range values for Md and PMTA were similar (2.6% vs 5.3%); there was excellent agreement between both indexes (K = 0.82).ConclusionsMaximum diameter and PMTA are convenient indexes to describe PM dimensions. However, given the high equivalence between both indexes, we propose the use of Md due to its simplicity and ease of calculation. Our findings suggest that patients with any PM diameter ≥12 mm should be considered abnormal.

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Solitary papillary muscle hypertrophy in young athletes

Cited by 3 publications

References 4 publications

Significance of isolated papillary muscle hypertrophy: A comparison of left ventricular hypertrophy diagnosed using electrocardiography vs echocardiography

Significance of isolated papillary muscle hypertrophy: A comparison of left ventricular hypertrophy diagnosed using electrocardiography vs echocardiography

Eleven patients with deformed papillary muscles and downward movement were misdiagnosed as cardiomyocyte ischemia due to giant negative T wave

Papillary muscles. Dark side of the heart: A simple approach for a forgotten structure

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