Mitral Regurgitation from Ischemic Papillary-Muscle Rupture

This clinical image report details a 59-year-old woman presenting with acute dyspnea, murmur, and imaging findings consistent with severe mitral regurgitation due to rupture of the anterolateral papillary muscle—an uncommon event owing to its dual arterial supply. Transthoracic and transesophageal echocardiography confirmed leaflet flail and muscle prolapse into the left atrium. Coronary angiography revealed multivessel disease with a culprit lesion in the left circumflex artery. The patient underwent emergency mitral valve replacement but declined further revascularization. One-year follow-up showed favorable medical management outcomes. The case highlights the diagnostic importance of echocardiography and individualized treatment strategies in ischemic mitral valve disease.

This clinical image report details a 59-year-old woman presenting with acute dyspnea, murmur, and imaging findings consistent with severe mitral regurgitation due to rupture of the anterolateral papillary muscle—an uncommon event owing to its dual arterial supply. Transthoracic and transesophageal echocardiography confirmed leaflet flail and muscle prolapse into the left atrium. Coronary angiography revealed multivessel disease with a culprit lesion in the left circumflex artery. The patient underwent emergency mitral valve replacement but declined further revascularization. One-year follow-up showed favorable medical management outcomes. The case highlights the diagnostic importance of echocardiography and individualized treatment strategies in ischemic mitral valve disease.