Complete rupture of the anterolateral papillary muscle caused by coronary spasm

• Published in: Interactive cardiovascular and thoracic surgery Vol. 21; no. 6; pp. 798 - 800
• Main Authors: Yamazaki, Masataka, Fukui, Toshihiro, Mahara, Keitaro, Takanashi, Shuichiro
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-12-2015
• Subjects: Aged; Coronary Vasospasm - complications; Coronary Vasospasm - diagnostic imaging; Echocardiography, Transesophageal; Female; Heart Rupture, Post-Infarction - diagnostic imaging; Heart Rupture, Post-Infarction - etiology; Heart Rupture, Post-Infarction - surgery; Humans; Mitral Valve Insufficiency - diagnostic imaging; Mitral Valve Insufficiency - etiology; Mitral Valve Insufficiency - surgery; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - etiology; Papillary Muscles - diagnostic imaging; Papillary Muscles - pathology; Papillary Muscles - surgery; Rupture; Coronary spasm; Acute mitral regurgitation; Anterolateral papillary muscle rupture; Mitral valve replacement
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivv237

Papillary muscle rupture usually occurs as a catastrophic complication of acute myocardial infarction in patients with coronary artery stenosis; it is therefore less common in patients without coronary artery stenosis. We report the case of a 67-year old woman without coronary artery stenosis who suffered an acute anterolateral papillary muscle rupture and was successfully treated with mitral valve replacement. Evidence of coronary spasm was found on a coronary vasomotion test, suggesting that a high sensitivity to coronary spasm may explain a mechanism of isolated papillary muscle infarction.