6533b82dfe1ef96bd1291e43
RESEARCH PRODUCT
Diagnosis of papillary muscle rupture after acute myocardial infarction by transthoracic and transesophageal echocardiography.
Raimund ErbelS. GenthJ. MeyerDohmen GZotz Rsubject
ThoraxMalemedicine.medical_specialtymedicine.medical_treatmentMitral valveInternal medicineMedicineEndocarditisHumansMyocardial infarctionEsophagusPapillary muscleAgedHeart Rupture Post-Infarctionbusiness.industryMitral valve replacementGeneral MedicineMiddle AgedPapillary Musclesmedicine.diseasemedicine.anatomical_structureEchocardiographyEvaluation Studies as TopicCardiologyFemaleRadiologyCardiology and Cardiovascular MedicinebusinessEchocardiography TransesophagealArterydescription
The sensitivity of transthoracic echocardiography to visualize the structural abnormality of papillary muscle rupture (PMR) after acute myocardial infarction can be anticipated to average about 50%; therefore, we evaluated five patients exhibiting the condition with both transthoracic and transesophageal echocardiography. The use of the two imaging techniques resulted in the fact that no instance of PMR was missed. Using transthoracic echocardiography in two patients and transesophageal echocardiography in four, the ruptured papillary muscle was visualized directly. Mitral insufficiency as an indirect sign was observed in all patients. In one patient the papillary muscle rupture developed in a mitral valve previously affected by endocarditis. All patients underwent mitral valve replacement and coronary artery bypass grafting. The diagnosis was confirmed at surgery in all patients. Four patients died in hospital, the fifth 5 months later. We recommended that transesophageal echocardiography be performed in patients with suspected PMR if transthoracic echocardiography does not provide an unequivocal diagnosis.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 1993-09-01 | Clinical cardiology |