Role of echocardiography in diagnosis and management of complete papillary muscle rupture caused by myocardial infarction

Aim To evaluate the usefulness of echocardiography in the diagnosis of complete rupture of papillary muscle. Methods Transthoracic (TTE) and transesophageal echocardiography (TEE) was performed with the ATL 3000 HDI Ultrasound Inc (Bothell, WA, USA) with a 2.5 MHz transducer and 5-7 MHz multiplan...

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Main Authors: Josip Vincelj, Stanko Biočić, Mario Udovičić, Mario Sičaja, Sandra Jakšić Jurinjak
Format: Article
Language:English
Published: Medical Association of Zenica-Doboj Canton 2015-08-01
Series:Medicinski Glasnik
Subjects:
Online Access:http://ljkzedo.ba/sites/default/files/Glasnik/MG23/05%20josip%20vincelj.pdf
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spelling doaj-2d88e1a1c54348d6a2f05056a2e4f1082020-11-24T22:44:29ZengMedical Association of Zenica-Doboj CantonMedicinski Glasnik1840-01321840-24452015-08-0112213313810.17392/793-15Role of echocardiography in diagnosis and management of complete papillary muscle rupture caused by myocardial infarctionJosip Vincelj0Stanko Biočić1Mario Udovičić2Mario Sičaja3Sandra Jakšić Jurinjak4Institute of Cardiovascular Diseases, Dubrava University Hospital, Zagreb; University of Applied Health Studies, Zagreb; School of Medicine, University J. J. Strossmayer, Osijek, CroatiaInstitute of Cardiovascular Diseases, Dubrava University Hospital, ZagrebInstitute of Cardiovascular Diseases, Dubrava University Hospital, ZagrebInstitute of Cardiovascular Diseases, Dubrava University Hospital, ZagrebInstitute of Cardiovascular Diseases, Dubrava University Hospital, ZagrebAim To evaluate the usefulness of echocardiography in the diagnosis of complete rupture of papillary muscle. Methods Transthoracic (TTE) and transesophageal echocardiography (TEE) was performed with the ATL 3000 HDI Ultrasound Inc (Bothell, WA, USA) with a 2.5 MHz transducer and 5-7 MHz multiplane phased array transducer. We are reporting about two patients (a 45 and a 51-year old male) with complete ruptures of papillary muscle following acute myocardial infarction (AMI). Results Both patients were previously treated with fibrinolysis in their local hospitals, 400 and 300 km, respectively, away from our hospital. Massive mitral regurgitation developed in both followed by rapid deterioration of hemodynamic state and severe heart failure, because of which both were transferred by helicopter to the Coronary Care Unit of our clinic. The diagnosis of complete papillary muscle rupture was confirmed in both patients by TTE and TEE. Due to the significant deterioration in their hemodynamic state, vasoactive drugs and intra-aortic balloon pump support were applied. Both patients then underwent mitral valve replacement, accompanied by concomitant coronary artery bypass grafting in one case. Conclusion Transesophageal echocardiography is a more accurate and rapid diagnostic method in patients with mechanical complications of AMI than TTE.http://ljkzedo.ba/sites/default/files/Glasnik/MG23/05%20josip%20vincelj.pdfmitral valvereplacementcoronary arterybypass grafting
collection DOAJ
language English
format Article
sources DOAJ
author Josip Vincelj
Stanko Biočić
Mario Udovičić
Mario Sičaja
Sandra Jakšić Jurinjak
spellingShingle Josip Vincelj
Stanko Biočić
Mario Udovičić
Mario Sičaja
Sandra Jakšić Jurinjak
Role of echocardiography in diagnosis and management of complete papillary muscle rupture caused by myocardial infarction
Medicinski Glasnik
mitral valve
replacement
coronary artery
bypass grafting
author_facet Josip Vincelj
Stanko Biočić
Mario Udovičić
Mario Sičaja
Sandra Jakšić Jurinjak
author_sort Josip Vincelj
title Role of echocardiography in diagnosis and management of complete papillary muscle rupture caused by myocardial infarction
title_short Role of echocardiography in diagnosis and management of complete papillary muscle rupture caused by myocardial infarction
title_full Role of echocardiography in diagnosis and management of complete papillary muscle rupture caused by myocardial infarction
title_fullStr Role of echocardiography in diagnosis and management of complete papillary muscle rupture caused by myocardial infarction
title_full_unstemmed Role of echocardiography in diagnosis and management of complete papillary muscle rupture caused by myocardial infarction
title_sort role of echocardiography in diagnosis and management of complete papillary muscle rupture caused by myocardial infarction
publisher Medical Association of Zenica-Doboj Canton
series Medicinski Glasnik
issn 1840-0132
1840-2445
publishDate 2015-08-01
description Aim To evaluate the usefulness of echocardiography in the diagnosis of complete rupture of papillary muscle. Methods Transthoracic (TTE) and transesophageal echocardiography (TEE) was performed with the ATL 3000 HDI Ultrasound Inc (Bothell, WA, USA) with a 2.5 MHz transducer and 5-7 MHz multiplane phased array transducer. We are reporting about two patients (a 45 and a 51-year old male) with complete ruptures of papillary muscle following acute myocardial infarction (AMI). Results Both patients were previously treated with fibrinolysis in their local hospitals, 400 and 300 km, respectively, away from our hospital. Massive mitral regurgitation developed in both followed by rapid deterioration of hemodynamic state and severe heart failure, because of which both were transferred by helicopter to the Coronary Care Unit of our clinic. The diagnosis of complete papillary muscle rupture was confirmed in both patients by TTE and TEE. Due to the significant deterioration in their hemodynamic state, vasoactive drugs and intra-aortic balloon pump support were applied. Both patients then underwent mitral valve replacement, accompanied by concomitant coronary artery bypass grafting in one case. Conclusion Transesophageal echocardiography is a more accurate and rapid diagnostic method in patients with mechanical complications of AMI than TTE.
topic mitral valve
replacement
coronary artery
bypass grafting
url http://ljkzedo.ba/sites/default/files/Glasnik/MG23/05%20josip%20vincelj.pdf
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