{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T18:50:22Z","timestamp":1780080622827,"version":"3.54.0"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,5,30]],"date-time":"2017-05-30T00:00:00Z","timestamp":1496102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2017,7]]},"abstract":"Background<\/jats:title>Acute myocardial infarctions (AMI<\/jats:styled-content>) continue to be common in the United States. Mechanical complications of AMI<\/jats:styled-content> can lead to cardiogenic shock (CS<\/jats:styled-content>) and death. The aim of this study was to review the cases of papillary muscle ruptures in the setting of myocardial infarctions at a tertiary care center, with a focus on the clinical presentation and echocardiographic diagnosis.<\/jats:p><\/jats:sec>Methods<\/jats:title>This was a retrospective study from January 1, 2000 through December 31, 2014. In all, 22 patients with AMI<\/jats:styled-content> and papillary muscle rupture (AMI<\/jats:styled-content>\u2010PMR<\/jats:styled-content>) who had surgical intervention were identified.<\/jats:p><\/jats:sec>Results<\/jats:title>The average age was 70 (\u00b111) with 16 (73%) males. Six patients presented with ST<\/jats:styled-content>\u2010elevation myocardial infarctions (STEMI<\/jats:styled-content>) and all underwent emergent revascularization with primary percutaneous coronary intervention (PCI<\/jats:styled-content>) prior to the diagnosis of AMI<\/jats:styled-content>\u2010PMR<\/jats:styled-content>. The other 16 patients presented with a non\u2010STEMI<\/jats:styled-content>. In total, 17 (77%) of the 22 patients were diagnosed with an AMI<\/jats:styled-content>\u2010PMR<\/jats:styled-content> within 7\u00a0days from their onset of symptoms. In all, 12 patients (55%) had anterolateral papillary muscle ruptures (ALPMR<\/jats:styled-content>), and the other 10 had posteromedial papillary muscle ruptures (PMPMR<\/jats:styled-content>). Ruptures were complete in 10 patients (45%). Patients presented with pulmonary edema early (<7\u00a0days) more commonly than late (>14\u00a0days). Transthoracic echocardiography was able to demonstrate severe mitral regurgitation in 86% and a definitive or suggestive diagnosis in 93%. All 22 patients survived to operative management, and the overall in\u2010hospital mortality rate was 9%.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In conclusion, ischemic papillary muscle ruptures continue to occur, but with prompt diagnosis by echocardiography and rapid surgical management, the mortality rate continues to decline.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.13585","type":"journal-article","created":{"date-parts":[[2017,5,31]],"date-time":"2017-05-31T02:07:33Z","timestamp":1496196453000},"page":"973-977","source":"Crossref","is-referenced-by-count":16,"title":["Clinical presentation and echocardiographic diagnosis of postinfarction papillary muscle rupture: A review of 22 cases"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1241-0328","authenticated-orcid":false,"given":"Bradley W.","family":"Ternus","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic Rochester MN 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