Isolated acute papillary muscle infarction in the absence of coronary artery disease resulting in cardiogenic shock and emergent mitral valve replacement

Cathet Cardiovasc Diagn. 1998 Feb;43(2):185-9. doi: 10.1002/(sici)1097-0304(199802)43:2<185::aid-ccd17>;2-n.


A 76-year-old woman presented to our institution with shortness of breath, weakness, and syncope. Evaluation revealed severe mitral regurgitation and cardiogenic shock secondary to a flail posterior mitral valve leaflet. An emergency cardiac catheterization did not demonstrate significant coronary artery disease. The patient was sent for an emergency mitral valve replacement. Intraoperatively, the posteromedial papillary muscle was found to be transected. Histological analysis, clinical presentation, and a review of the literature of isolated papillary muscle infarction are presented.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Aged
  • Electrocardiography
  • Emergency Treatment
  • Female
  • Heart Rupture / complications*
  • Heart Rupture / diagnosis
  • Heart Rupture / pathology
  • Humans
  • Mitral Valve Insufficiency / etiology*
  • Mitral Valve Insufficiency / pathology
  • Mitral Valve Insufficiency / surgery
  • Myocardial Infarction / complications*
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / pathology
  • Papillary Muscles* / pathology
  • Shock, Cardiogenic / diagnosis
  • Shock, Cardiogenic / etiology*