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at 2:38 p.m. Nov, 29, 2024
by
Ahmed7
Author:
Brian_BH
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- Presents with sudden-onset pulmonary edema, hypotension, and a systolic murmur (cardiac apex)
- Ischemia → papillary muscle rupture → mitral regurgitation leading to pulmonary edema


- Due to macrophage-mediated structural degradation
- Presents with sudden-onset pulmonary edema, hypotension, and a systolic murmur (cardiac apex)
- Ischemia → papillary muscle rupture → mitral regurgitation leading to pulmonary edema
*Posteromedial papillary muscle is supplied by the PDA (assuming right-dominant look for RCA infarct, ST elevations from leads II, III, and aVF can be seen)

Photo credit: Zorkun, CC BY-SA 3.0, via Wikidocs

Lecture Notes
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Missed Questions
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Pathoma
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Boards and Beyond
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First Aid




Sketchy




Watch Acute Myocardial Infarction & Post MI Timeline



Watch Mitral Valve Regurgitation & Prolapse



Watch Coronary Circulation




Watch Coronary Circulation: Clinical Correlates







Watch Mitral Valve Regurgitation & Prolapse



Watch Coronary Circulation




Watch Coronary Circulation: Clinical Correlates
Sketchy 2




Watch MI Complications SOAP




Watch Mitral Regurgitation & Mitral Valve Prolapse SOAP





Watch Shock: Cardiogenic & Obstructive SOAPs












Watch MI Complications SOAP




Watch Mitral Regurgitation & Mitral Valve Prolapse SOAP





Watch Shock: Cardiogenic & Obstructive SOAPs








Sketchy Extra
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Picmonic
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Physeo
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Bootcamp
Watch associated Bootcamp video - Post-Myocardial Infarction Timeline
Watch associated Bootcamp video - Valvular Disease: Mitral Regurgitation
Watch associated Bootcamp video - Valvular Disease: Mitral Regurgitation
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Additional Resources






Papillary muscle rupture
Photograph of a heart at autopsy (close-up of the left ventricle in longitudinal section)
The posteromedial papillary muscle of the mitral valve has ruptured and almost completely detached from its ventricular attachment.
This is the characteristic appearance of papillary muscle rupture, a complication of myocardial infarction. The posteromedial papillary muscle is supplied by the posterior descending artery and is susceptible to ischemia and rupture in individuals with critical occlusion of this artery.

Ruptured papillary muscle
Photograph of a heart at autopsy (close-up of the left ventricle in longitudinal section)
The anterolateral papillary muscle of the mitral valve has avulsed from its ventricular attachment. The posteromedial papillary muscle is mostly intact, except for a small area of ischemic necrosis near its attachment to the chordae tendineae. The chordae tendineae are the white strings connecting the papillary muscles to the mitral valve.
This is the characteristic appearance of papillary muscle rupture, a complication of myocardial infarction.
→ acute onset of pulmonary edema, hypotension, dyspnea/tachypnea, and soft systolic murmur (MR)


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