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Cardiac
Diagnosis
Coronary Artery Disease
Papillary Muscle Rupture
Papillary Muscle Rupture
Jonathan D. Dodd, MD, MSc, MRCPI, FFR(RCSI); Darragh Brady, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Partial or complete rupture of papillary muscle, most commonly in setting of acute myocardial infarction

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Echocardiographic Findings

                      • Angiographic Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              CLINICAL ISSUES

                              • Presentation

                                • Natural History & Prognosis

                                  • Treatment

                                    Selected References

                                    1. Geis N et al: Percutaneous repair of severe mitral valve regurgitation secondary to chordae rupture in octogenarians using MitraClip. J Interv Cardiol. 31(1):76-82, 2018
                                    2. Harari R et al: Papillary muscle rupture following acute myocardial infarction: Anatomic, echocardiographic, and surgical insights. Echocardiography. 34(11):1702-7, 2017
                                    3. Zoghbi WA et al: Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation: A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr. 30(4):303-71, 2017
                                    4. Hansen AJ et al: Postpartum rupture of the posteromedial papillary muscle. J Card Surg. 27(3):313-6, 2012
                                    5. Fradley MG et al: Rupture of the posteromedial papillary muscle leading to partial flail of the anterior mitral leaflet. Circulation. 123(9):1044-5, 2011
                                    6. Tanimoto T et al: Prevalence and clinical significance of papillary muscle infarction detected by late gadolinium-enhanced magnetic resonance imaging in patients with ST-segment elevation myocardial infarction. Circulation. 122(22):2281-7, 2010
                                    7. Bizzarri F et al: Cardiogenic shock as a complication of acute mitral valve regurgitation following posteromedial papillary muscle infarction in the absence of coronary artery disease. J Cardiothorac Surg. 3:61, 2008
                                    8. Carrillo X et al: Mitral valve repair surgery for traumatic rupture of the anterolateral papillary muscle. Rev Esp Cardiol. 61(12):1360-1, 2008
                                    9. Czarnecki A et al: Acute severe mitral regurgitation: consideration of papillary muscle architecture. Cardiovasc Ultrasound. 6:5, 2008
                                    10. Russo A et al: Clinical outcome after surgical correction of mitral regurgitation due to papillary muscle rupture. Circulation. 118(15):1528-34, 2008
                                    11. Sanchez CE et al: Survival from combined left ventricular free wall rupture and papillary muscle rupture complicating acute myocardial infarction. J Am Soc Echocardiogr. 20(7):905, 2007
                                    12. Marangelli V et al: Images in cardiovascular medicine. Three-dimensional imaging in rupture of papillary muscle after acute myocardial infarction. Circulation. 111(23):e385-7, 2005
                                    13. Whiting PC et al: Transesophageal echocardiographic findings in papillary muscle rupture. Anesth Analg. 101(5):1292-3, 2005
                                    14. Weiss SR et al: Isolated acute papillary muscle infarction in the absence of coronary artery disease resulting in cardiogenic shock and emergent mitral valve replacement. Cathet Cardiovasc Diagn. 43(2):185-9, 1998
                                    15. Barbour DJ et al: Rupture of a left ventricular papillary muscle during acute myocardial infarction: analysis of 22 necropsy patients. J Am Coll Cardiol. 8(3):558-65, 1986
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Definitions

                                                • Partial or complete rupture of papillary muscle, most commonly in setting of acute myocardial infarction

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • MR Findings

                                                      • Echocardiographic Findings

                                                        • Angiographic Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      Selected References

                                                                      1. Geis N et al: Percutaneous repair of severe mitral valve regurgitation secondary to chordae rupture in octogenarians using MitraClip. J Interv Cardiol. 31(1):76-82, 2018
                                                                      2. Harari R et al: Papillary muscle rupture following acute myocardial infarction: Anatomic, echocardiographic, and surgical insights. Echocardiography. 34(11):1702-7, 2017
                                                                      3. Zoghbi WA et al: Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation: A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr. 30(4):303-71, 2017
                                                                      4. Hansen AJ et al: Postpartum rupture of the posteromedial papillary muscle. J Card Surg. 27(3):313-6, 2012
                                                                      5. Fradley MG et al: Rupture of the posteromedial papillary muscle leading to partial flail of the anterior mitral leaflet. Circulation. 123(9):1044-5, 2011
                                                                      6. Tanimoto T et al: Prevalence and clinical significance of papillary muscle infarction detected by late gadolinium-enhanced magnetic resonance imaging in patients with ST-segment elevation myocardial infarction. Circulation. 122(22):2281-7, 2010
                                                                      7. Bizzarri F et al: Cardiogenic shock as a complication of acute mitral valve regurgitation following posteromedial papillary muscle infarction in the absence of coronary artery disease. J Cardiothorac Surg. 3:61, 2008
                                                                      8. Carrillo X et al: Mitral valve repair surgery for traumatic rupture of the anterolateral papillary muscle. Rev Esp Cardiol. 61(12):1360-1, 2008
                                                                      9. Czarnecki A et al: Acute severe mitral regurgitation: consideration of papillary muscle architecture. Cardiovasc Ultrasound. 6:5, 2008
                                                                      10. Russo A et al: Clinical outcome after surgical correction of mitral regurgitation due to papillary muscle rupture. Circulation. 118(15):1528-34, 2008
                                                                      11. Sanchez CE et al: Survival from combined left ventricular free wall rupture and papillary muscle rupture complicating acute myocardial infarction. J Am Soc Echocardiogr. 20(7):905, 2007
                                                                      12. Marangelli V et al: Images in cardiovascular medicine. Three-dimensional imaging in rupture of papillary muscle after acute myocardial infarction. Circulation. 111(23):e385-7, 2005
                                                                      13. Whiting PC et al: Transesophageal echocardiographic findings in papillary muscle rupture. Anesth Analg. 101(5):1292-3, 2005
                                                                      14. Weiss SR et al: Isolated acute papillary muscle infarction in the absence of coronary artery disease resulting in cardiogenic shock and emergent mitral valve replacement. Cathet Cardiovasc Diagn. 43(2):185-9, 1998
                                                                      15. Barbour DJ et al: Rupture of a left ventricular papillary muscle during acute myocardial infarction: analysis of 22 necropsy patients. J Am Coll Cardiol. 8(3):558-65, 1986