A Case of Left Ventricular Rupture and Complete Rupture of both Papillary Muscles Following Blunt Chest Trauma

ABSTRACT

Blunt chest trauma can cause various types of cardiac injuries such as myocardial contusion,cardiac ruptrue, valvular or papillary muscle injuries, and pericardial or coronary artery injuries. Complete rupture of both papillary muscles accompanied by left ventricular(LV) rupture following blunt chest trauma to our knowledge has not been previously reported. A 40-year-old female was referred because of severe dyspnea and anterior chest pain which occured immedicately after blunt chest trauma. Echocardiography demonstrated a moderate pericardial effusion as well as rupture of both papillary muscle with severe mitral regurgitation. Hemopericardium and a complets tear of the anterolateral papillary muscle at the mid portion were observed. The posteromedial papillary muscle was totally transected at the attachment site of LV wall and accompanied by external rupture of left ventricle at that site. Mitral valve replacement and primary repair of LV ruptrue was performed successfully. In the case we report, complete rupture of both papillary muscles developed after blunt chest trauma and LV rupture occurred as the papillary muscle was torn from the LV wall.