Abstract
BackgroundThe rupture of the anterolateral papillary muscle is less common than the posteromedial papillary muscle since the anterolateral muscle has dual blood supplies, while the posteromedial papillary muscle has a single blood supply.Case presentationWe present a case report of a 42 year old male presenting with heart failure being diagnosed to have mitral regurgitation from the partial rupture of the anterolateral papillary muscle due to coronary artery disease. The patient underwent a mitral valve replacement and concomitant coronary artery bypass grafting of the first and the second obtuse marginal arteries.ConclusionAcute mitral regurgitation can be precipitated by acute myocardial infarction due to rupture of the anterolateral papillary muscle.
Highlights
The rupture of the anterolateral papillary muscle is less common than the posteromedial papillary muscle since the anterolateral muscle has dual blood supplies, while the posteromedial papillary muscle has a single blood supply.Case presentation: We present a case report of a 42 year old male presenting with heart failure being diagnosed to have mitral regurgitation from the partial rupture of the anterolateral papillary muscle due to coronary artery disease
Papillary muscle rupture is usually seen in relatively small area infarctions, often with modest coronary disease extent revealed by angiogram [1]
We presented the case of a patient admitted status postacute myocardial infarction secondary to the occlusion of the first obtuse marginal, with consequent mitral regurgitation (MR) as a mechanical complication of the MI and congestive heart failure
Summary
Rupture of a papillary muscle is an uncommon but often fatal complication of acute myocardial infarction (MI) which is responsible for approximately 5% of death after MI [1]. The rupture of the anterolateral muscle is less common, occurring in 25% of cases, as it has dual blood supplies: from the first obtuse marginal, originating from the left circumflex; and from the first diagonal branch, originating from the left anterior descending. The rupture of the latter is seen with anterolateral MI [2,3,4]. The patient underwent a mitral valve replacement with a St Jude mechanical valve and concomitant coronary artery bypass grafting of the first and the second obtuse marginal arteries (fig 4) He had an uneventful recovery, and was discharged with minimal dyspnea on exertion. A valve replacement – and a functional mechanical mitral valve with no paravalvular leaks
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