Cardiogenic shock as a complication of acute mitral valve regurgitation following posteromedial papillary muscle infarction in the absence of coronary artery disease

A 48 year old man was transferred to our department with cardiogenic shock, pyrexia, a high white cell count and significant serum troponin T level. Clinical evaluation revealed severe mitral regurgitation secondary to a flail of both mitral valve leaflets. An emergency cardiac catheterisation did n...

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Bibliographic Details
Published in:Journal of cardiothoracic surgery 2008-11, Vol.3 (1), p.61-61, Article 61
Main Authors: Bizzarri, Federico, Mattia, Consalvo, Ricci, Massimo, Coluzzi, Flaminia, Petrozza, Vincenzo, Frati, Giacomo, Pugliese, Giuseppe, Muzzi, Luigi
Format: Article
Language:English
Subjects:
Acute Disease
Cardiogenic shock
Cardiomyopathy
Case Report
Case studies
Complications and side effects
Development and progression
Diagnosis
Heart diseases
Heart Valve Prosthesis
Humans
Infarction - complications
Male
Middle Aged
Mitral Valve - surgery
Mitral valve insufficiency
Mitral Valve Insufficiency - complications
Mitral Valve Insufficiency - etiology
Mitral Valve Insufficiency - surgery
Necrosis
Papillary Muscles
Rupture - etiology
Shock, Cardiogenic - etiology
Troponin T - blood
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Summary:A 48 year old man was transferred to our department with cardiogenic shock, pyrexia, a high white cell count and significant serum troponin T level. Clinical evaluation revealed severe mitral regurgitation secondary to a flail of both mitral valve leaflets. An emergency cardiac catheterisation did not reveal any significant coronary artery disease. Left ventricular angiogram and echocardiography demonstrated a good left ventricular function and massive mitral regurgitation. Blood cultures were negative for aerobics, anaerobics and fungi. The patient underwent emergency mitral valve replacement with a mechanical valve. Intraoperatively, the posteromedial papillary muscle was found to be ruptured. Histology of the papillary muscle revealed myocardial necrosis with no signs of infection. Cultures obtained from a mitral valve specimen were negative. The patient's recovery was uneventful and he was discharged on the 6th postoperative day.
ISSN:1749-8090
1749-8090
DOI:10.1186/1749-8090-3-61