papillary muscle rupture
Catastrophic complication where a papillary muscle tears, usually following myocardial infarction, causing severe mitral regurgitation.
Full Definition
A life-threatening complication most commonly occurring 2-7 days following acute myocardial infarction, where one of the papillary muscles supporting the mitral valve apparatus ruptures partially or completely. The posteromedial papillary muscle is more frequently affected due to its single blood supply from the posterior descending artery, while the anterolateral papillary muscle has dual supply from both left anterior descending and circumflex systems. Papillary muscle rupture results in acute severe mitral regurgitation with rapid hemodynamic deterioration, pulmonary edema, and cardiogenic shock. Complete rupture is usually fatal without immediate surgical intervention, while partial rupture may present with varying degrees of mitral insufficiency. Emergency surgical repair typically involves mitral valve replacement rather than repair due to the extent of tissue damage, though repair may be possible in cases of partial rupture with adequate remaining muscle tissue.
Usage
Usage note: Specify complete versus partial rupture and which papillary muscle (posteromedial or anterolateral) is affected.
In Context
- "Emergency surgery was performed for complete papillary muscle rupture with acute severe mitral regurgitation." — emergency operative report
- "The posteromedial papillary muscle showed partial rupture requiring mitral valve replacement." — surgical findings