Anterolateral Papillary Muscle Rupture Caused by Myocardial Infarction: A case report

Abstract Background: The rupture of the anterolateral papillary muscle is less common than the posteromedial papillary muscle since the anterolateral muscle has dual blood supplies, while the posteromedial papillary muscle has a single blood supply. Case presentation: We present a case report of a 62 year old Sudanese male presenting with acute inferior ST segment elevation myocardial infarction (STEMI), underwent primary PCI (percutaneous intervention) to the right coronary artery. One hour after the PCI, he had sudden heart failure Kilip class IV, with significant shortness of breath, required intubation. Diagnosed to have mitral regurgitation from the complete rupture of the anterolateral papillary muscle due to coronary artery disease. The Transthoracic images were not enough to show the mitral valve apparatus and the transeophageal echocardiography as a gold standard showed clearly the rupture of the antero-lateral papillary muscle. The patient underwent a mitral valve replacement and concomitant coronary artery bypass grafting of the right coronary artery and left circumflex artery. Conclusion: Acute mitral regurgitation can be precipitated by acute myocardial infarction due to rupture of the anterolateral papillary muscle.