Abstract
A 44-year-old woman with primary myocardial disease was found to have fibrosis of the posterior papillary muscle of the left ventricle. The fibrosis also involved the free wall of the left ventricle just beneath this papillary muscle. In patients with primary myocardial disease who have mitral insufficiency, papillary muscle fibrosis should be considered as a possible cause of this murmur.
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