An 80-Year-Old Man with Inferior Wall Myocardial
Infarction and Cardiogenic Shock: Case Report
Korakoth Towashiraporn MD*, Decho Jakrapanichakul MD**,
Wanchai Wongkornrat MD***, Rungroj Krittayaphong MD**
Affiliation :
* Her Majesty Cardiac Center, Siriraj Hospital, Mahidol University, Bangkok, Thailand
** Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
*** Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital,
Mahidol University, Bangkok, Thailand
We report a case of ruptured head of posteromedial papillary muscle and prolapse of anterior mitral valve leaflet
that caused severe mitral regurgitation (MR) and cardiogenic shock as a complication of inferior wall myocardial infarction
in an 80-year-old man. Emergency coronary angiogram revealed thrombotic occlusion at proximal right coronary artery.
Transesophageal echocardiogram revealed ruptured head of posteromedial papillary muscle and prolapse of anterior mitral
valve leaflet causing severe MR. After percutaneous coronary intervention with bare metal stent, the patient underwent
mitral valve repair with saphenous vein graft to the posterolateral branch of the right coronary artery. The patient was
discharged from hospital on day 14 of admission.
Keywords : Complication of inferior wall myocardial infarction, Ruptured head of papillary muscle
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