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Acute torrential mitral regurgitation secondary to iatrogenic papillary muscle rupture
  1. Christopher Bernard Marsalisi1,
  2. Loruanma Lam2,
  3. Julien Feghaly3 and
  4. Dinesh Kadariya2
  1. 1Internal Medicine, University of Florida College of Medicine, Jacksonville, Florida, USA
  2. 2University of Florida College of Medicine, Jacksonville, Florida, USA
  3. 3Cardiology, University of Florida College of Medicine, Jacksonville, Jacksonville, Florida, USA
  1. Correspondence to Dr Christopher Bernard Marsalisi; Christopher.marsalisi{at}jax.ufl.edu

Abstract

Papillary Muscle rupture is a rare and potentially life-threatening complication that is typically observed in the days following acute myocardial infarction. Less commonly, rupture of a papillary muscle may arise as an iatrogenic complication of cardiac procedures. We present a case of cardiogenic shock in the setting of torrential mitral regurgitation secondary to iatrogenic papillary muscle rupture during a left ventricular angiogram. The patient was placed on percutaneous mechanical circulatory support with Impella CP and transferred for emergent mitral valve replacement. This case highlights the potential complications of minimally invasive cardiac procedures and reviews the management of acute severe mitral regurgitation.

  • Valvar diseases
  • Heart failure
  • Mechanical ventilation
  • Adult intensive care

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Footnotes

  • X @julien_feghaly

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: CBM, LL, JF and DK. The following authors gave final approval of the manuscript: DK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.