Case Report: Non-ischemic Papillary Muscle Rupture due to MRSA Myocarditis with Concurrent Thromboembolic Myocardial Infarction Secondary to Infective Endocarditis

Non-ischemic papillary muscle rupture (PMR) is rare. PMR caused by myocarditis in the presence of concurrent infective endocarditis (IE) and myocardial infarction (MI) has not been described. We report a 46-year-old male with recurrent MRSA bacteremia who presented in septic shock and suffered cardi...

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Bibliographic Details
Published in:	South Dakota medicine Vol. 77; no. 7; p. 304
Main Authors:	Maryniak, Andrii, Oleszak, Filip, Huang, Jiannan, Maziarz, David, Stys, Tomasz, Stys, Adam
Format:	Journal Article
Language:	English
Published:	United States 01-07-2024
Subjects:	Echocardiography Endocarditis, Bacterial - complications Endocarditis, Bacterial - diagnosis Endocarditis, Bacterial - microbiology Humans Male Methicillin-Resistant Staphylococcus aureus - isolation & purification Middle Aged Myocardial Infarction - complications Myocardial Infarction - diagnosis Myocardial Infarction - etiology Myocarditis - complications Myocarditis - diagnosis Myocarditis - microbiology Papillary Muscles Staphylococcal Infections - complications Staphylococcal Infections - diagnosis Thromboembolism - etiology
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Summary:	Non-ischemic papillary muscle rupture (PMR) is rare. PMR caused by myocarditis in the presence of concurrent infective endocarditis (IE) and myocardial infarction (MI) has not been described. We report a 46-year-old male with recurrent MRSA bacteremia who presented in septic shock and suffered cardiac arrest. Echocardiography revealed acute mitral valve regurgitation resulting from posteromedial PMR. An intra-aortic balloon pump was implanted. Angiography revealed thrombotic occlusion of a small distal left circumflex artery. Emergent mitral valve replacement surgery was performed. MRSA myocarditis and IE were diagnosed by tissue cultures. Coexistence of myocarditis, IE, and MI poses a challenge in determining etiology.
ISSN:	0038-3317