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• W2618403520 abstract "Background Acute myocardial infarctions ( AMI ) continue to be common in the United States. Mechanical complications of AMI can lead to cardiogenic shock ( CS ) and death. The aim of this study was to review the cases of papillary muscle ruptures in the setting of myocardial infarctions at a tertiary care center, with a focus on the clinical presentation and echocardiographic diagnosis. Methods This was a retrospective study from January 1, 2000 through December 31, 2014. In all, 22 patients with AMI and papillary muscle rupture ( AMI ‐ PMR ) who had surgical intervention were identified. Results The average age was 70 (±11) with 16 (73%) males. Six patients presented with ST ‐elevation myocardial infarctions ( STEMI ) and all underwent emergent revascularization with primary percutaneous coronary intervention ( PCI ) prior to the diagnosis of AMI ‐ PMR . The other 16 patients presented with a non‐ STEMI . In total, 17 (77%) of the 22 patients were diagnosed with an AMI ‐ PMR within 7 days from their onset of symptoms. In all, 12 patients (55%) had anterolateral papillary muscle ruptures ( ALPMR ), and the other 10 had posteromedial papillary muscle ruptures ( PMPMR ). Ruptures were complete in 10 patients (45%). Patients presented with pulmonary edema early (<7 days) more commonly than late (>14 days). Transthoracic echocardiography was able to demonstrate severe mitral regurgitation in 86% and a definitive or suggestive diagnosis in 93%. All 22 patients survived to operative management, and the overall in‐hospital mortality rate was 9%. Conclusion In conclusion, ischemic papillary muscle ruptures continue to occur, but with prompt diagnosis by echocardiography and rapid surgical management, the mortality rate continues to decline." @default.
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• W2618403520 date "2017-05-30" @default.
• W2618403520 modified "2023-10-18" @default.
• W2618403520 title "Clinical presentation and echocardiographic diagnosis of postinfarction papillary muscle rupture: A review of 22 cases" @default.
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• W2618403520 doi "https://doi.org/10.1111/echo.13585" @default.
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