The Diffcult Diagnosis of Ischaemic Papillary Muscle Rupture Case report from an urban emergency department
Journal Title: Sultan Qaboos University Medical Journal - Year 2016, Vol 16, Issue 2
Abstract
We present a rare case of severe ischaemic papillary muscle rupture in a 67-year-old male patient who was admitted to the Emergency Department of the University Hospital Bern, Switzerland, in November 2013 with acute chest pain. On admission, the patient’s blood pressure was 60/40 mm/Hg, his pulse was 110 beats per minute and his respiratory rate was 20 breaths per minute. An electrocardiogram was normal and focused assessment with sonography in trauma was negative. Transthoracic echocardiography showed possible thickening of the mitral valve leaflet with no indications of severe mitral insufciency or wall motion abnormalities. Triple-ruleout computed tomography angiography revealed no pulmonary emboli or aortic dissection, although coronary atherosclerosis was present. Finally, severe insufciency of the mitral valve with rupture of the papillary muscle, likely due to ischaemia, was observed via transoesophageal echocardiography. Te patient underwent a successful surgical intervention and was discharged 10 days later in stable condition.
Authors and Affiliations
Christian T. Braun| Emergency Department, University Hospital Bern, Switzerland, Meret E. Ricklin| Emergency Department, University Hospital Bern, Switzerland, Aristomenis K. Exadaktylos| Emergency Department, University Hospital Bern, Switzerland
Keywords
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