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Case Reports
. 2022 May 5;14(5):e24744.
doi: 10.7759/cureus.24744. eCollection 2022 May.

Atypical Presentation of Acute Mitral Regurgitation Secondary to Papillary Muscle Rupture

Kushal H Porwal  1 , Mokshal H Porwal  2 , Mohammed M Ibrahim  3 , Hariharan Ramaswamykanive  3 , Krishan Gupta  1 , Manu Mathur  4 , Seshasayee Narasimhan  5   6   7
Affiliations
Case Reports

Atypical Presentation of Acute Mitral Regurgitation Secondary to Papillary Muscle Rupture

Kushal H Porwal et al. Cureus. .

Abstract

Acute mitral regurgitation (MR) is a life-threatening condition presenting with severe decompensated heart failure due to sudden retrograde blood flow into the left atrium. The causes are broadly classified into ischemic and non-ischemic. Rapid and accurate diagnosis of acute MR and its potential causes is essential. This case uniquely highlights an atypical presentation of severe MR secondary to papillary muscle rupture without a known, identifiable cause. Therefore, suspicion of acute MR should be high if clinical symptoms are present, even without known risk factors, due to the high morbidity and mortality associated with delayed management.

Keywords: acute mitral regurgitation; cardiogenic shock; flail mitral leaflet; mitral regurgitation; papillary muscle rupture.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Transoesophageal echocardiogram demonstrating flail anterior mitral leaflet.
Figure 2
Figure 2. Close-up transoesophageal echocardiogram demonstrating posteriorly directed eccentric jet of severe mitral regurgitation.
Figure 3
Figure 3. Transoesophageal echocardiogram demonstrating posteriorly directed eccentric jet of severe mitral regurgitation including flow reversal into the left lower pulmonary vein.
Figure 4
Figure 4. Ruptured papillary muscle with attached anterior mitral leaflet.
See this image and copyright information in PMC

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