Abstract
Papillary muscle dysfunction is an extremely rare complication of acute myocardial infarction. Ischemic or necrotic lesions may impair one or two of the papillary muscles to such an extent that the anchoring function and closure of the mitral valves is no longer effective. Without shortening of the papillary muscles in systole, coaptation of valve leaflets anchored by the chordae tendineae is inadequate which leads to a gap in closure. The result is mitral insufficiency with a holosystolic murmur that is heard best at the cardiac apex and radiates into the axilla. Occasionally, only a late systolic murmur is found indicating that the papillary muscle functions in early systole but later demonstrates its ischemia-induced functional impairment in being unable to maintain the state of contraction to the end of systole.
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Literature
Bussmann WD (1982) Disorders of cardiac function in acute myocardial infarction. In: Roskamm H, Csapo G (eds) Disorders of cardiac function. Dekker, New York Basel, pp 169–218
Bussmann WD, Neumann K, Kaltenbach M (1980) Die Wirkung von Nitroglycerin auf die ventrikuläre Extrasystolie beim frischen Herzinfarkt. Dtsch Med Wochenschr 105: 369–373
Chatterjee K, Parmley WW, Swan HJC, Berman G, Forrester J, Marcus HS (1973) Beneficial effects of vasodilator agents in severe mitral regurgitation due to dysfunction of sub valvular apparatus. Circulation 48: 684–690
Chatterjee K, Ports TA, Parmley WFF (1979) Nitroprusside: Its clinical pharmacology and application in acute heart failure. In: Gould L, Reddy CVR (eds) Vasodilator therapy for cardiac disorders. Futura, Mount Kisco New York, pp 25–62
Greenberg BH, Massie BM, Brundage BH, Botvinick EH, Parmley WW, Chatterjee K (1978) Beneficial effects of hydralazine in severe mitral regurgitation. Circulation 62: 181–187
Harshaw CW, Grossman W, Munro AB, McLaurien LP (1975) Reduced systemic vascular resistance as therapy for severe mitral regurgitation of valvular origin. Ann Intern Med 83: 312
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© 1986 Springer-Verlag Berlin Heidelberg
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Bussmann, WD. (1986). Left-Sided Heart Failure and Papillary Muscle Dysfunction. In: Acute and Chronic Heart Failure. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-61627-3_6
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DOI: https://doi.org/10.1007/978-3-642-61627-3_6
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-64890-8
Online ISBN: 978-3-642-61627-3
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