Abstract
Serial echocardiograms were recorded in 25 patients with acute myocardial infarction. Significant variations in the diastolic slope as well as in the amplitude of the mitral valve echocardiogram were found in six patients (24 per cent). An apical systolic murmur was audible in each of the six patients. Day-to-day variations in the degree of the diastolic slope as well as in the intensity of the apical systolic murmur were attributed to alterations in the dynamic (contractile) state of the papillary muscles. Thus, during the early stages of acute myocardial infarction, ischemia and/or infarction of a papillary muscle render the muscle partially or totally incapable of shortening. Failure of the muscle to shorten results in mitral regurgitation. The echocardiogram offers a safe and convenient method for studying the day-to-day variations in papillary muscle function.
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