Kono Takanori, Takagi Kazuyoshi, Negoto Shinya, Tayama Eiki
Department of Surgery, Division of Cardiovascular Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume City, Fukuoka, Japan.
Case Rep Cardiol. 2022 Jul 8;2022:7149724. doi: 10.1155/2022/7149724. eCollection 2022.
Papillary muscle rupture is a catastrophic condition, of which most cases manifest posterior papillary muscle rupture. Anterior papillary muscle rupture is a rare condition. Particularly, anterior papillary muscle rupture due to acute myocardial microinfarction of the small high lateral branch is extremely rare. Since papillary muscle rupture can occur even in such a small branch or small area due to myocardial infarction, echocardiographic and/or ventriculographic confirmation is essential in cases of sudden worsening of heart failure. Herein, we report the case of anterior papillary muscle rupture with a good outcome. A 61-year-old man was admitted to our hospital with cardiogenic shock. Echocardiography revealed severe mitral regurgitation due to papillary muscle rupture. Coronary angiography demonstrated high-grade stenosis in the high lateral branch. However, no other significant stenoses were found. Emergency mitral valve replacement was performed. The patient was discharged 19 days after surgery without any complications.
乳头肌破裂是一种灾难性疾病，大多数病例表现为后乳头肌破裂。前乳头肌破裂是一种罕见的情况。特别是，由于小的高位外侧支急性心肌微梗死导致的前乳头肌破裂极为罕见。由于心肌梗死即使在如此小的分支或小区域也可能发生乳头肌破裂，因此在心力衰竭突然恶化的病例中，超声心动图和/或心室造影确认至关重要。在此，我们报告一例前乳头肌破裂且预后良好的病例。一名61岁男性因心源性休克入住我院。超声心动图显示因乳头肌破裂导致严重二尖瓣反流。冠状动脉造影显示高位外侧支高度狭窄。然而，未发现其他明显狭窄。进行了急诊二尖瓣置换术。患者术后19天出院，无任何并发症。
