The Difficult Diagnosis of Ischaemic Papillary Muscle Rupture: Case report from an urban emergency department.

Braun, Christian Tasso; Ricklin, Meret; Exadaktylos, Aristomenis (2016). The Difficult Diagnosis of Ischaemic Papillary Muscle Rupture: Case report from an urban emergency department. Sultan Qaboos University medical journal, 16(2), e234-e237. Sultan Qaboos University 10.18295/squmj.2016.16.02.016

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We present a rare case of severe ischaemic papillary muscle rupture in a 67-year-old male patient who was admitted to the Emergency Department of the University Hospital Bern, Switzerland, in November 2013 with acute chest pain. On admission, the patient's blood pressure was 60/40 mm/Hg, his pulse was 110 beats per minute and his respiratory rate was 20 breaths per minute. An electrocardiogram was normal and focused assessment with sonography in trauma was negative. Transthoracic echocardiography showed possible thickening of the mitral valve leaflet with no indications of severe mitral insufficiency or wall motion abnormalities. Triple-rule-out computed tomography angiography revealed no pulmonary emboli or aortic dissection, although coronary atherosclerosis was present. Finally, severe insufficiency of the mitral valve with rupture of the papillary muscle, likely due to ischaemia, was observed via transoesophageal echocardiography. The patient underwent a successful surgical intervention and was discharged 10 days later in stable condition.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center

UniBE Contributor:

Braun, Christian Tasso; Ricklin, Meret and Exadaktylos, Aristomenis

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2075-051X

Publisher:

Sultan Qaboos University

Language:

English

Submitter:

Romana Saredi

Date Deposited:

10 May 2017 16:14

Last Modified:

10 May 2017 16:21

Publisher DOI:

10.18295/squmj.2016.16.02.016

PubMed ID:

27226917

Uncontrolled Keywords:

Case Report; Echocardiography; Emergency Medicine; Heart Rupture; Myocardial Infarction; Papillary Muscles; Shock; Switzerland

BORIS DOI:

10.7892/boris.94948

URI:

https://boris.unibe.ch/id/eprint/94948

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