[Acute papillary muscle rupture and mitral valve insufficiency after myocardial infarction. Serious condition, but potentially curable through emergency surgery].

Acute papillary muscle rupture resulting in severe mitral regurgitation is an infrequent but extremely serious mechanical complication of myocardial infarction. The immediate and severe volume overload on the pulmonary circulation may cause pulmonary edema and circulatory shock with secondary organ failure. Diagnosis is preferably based on echocardiography, and urgent mitral valve replacement is the treatment of choice. This paper describes two such patients who were successfully treated by surgery despite cardiogenic shock. In addition, it illustrates the known fact that a papillary muscle rupture may be caused by a myocardial infarct of limited size but with an unfortunate location.