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Structure & Function of the Heart: Risk factors for Coronary Artery disease: Coronary Artery Disease:
Emergency Complications of Heart Attack:
Coronary Artery Bypass Grafting (CABG):
Rheumatic Fever and Heart Valve Diseases:
Heart Transplantation and Assisted devices
Important Heart Questions and Answers Common Drugs Used For Treatment of Heart Diseases Have your Child been diagnosed with a Congenital Heart Disease??
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Papillary muscle rupture due to Heart attack Papillary muscles are small finger like structures that arise from the wall of the left ventricle and are attached to the leaflets of mitral valve by small filaments called chrodae tendinae. When a patient develops a heart attack, those papillary muscles that control the mitral valve, may be involved in the heart attack. The entire muscle may become detached from the ventricular wall. If this happens, the mitral valve will no longer function effectively because of this sudden mitral valve incompetence. As a result blood will flow backwards into the lungs, and they will fill with fluid. Since this problem happens very fast, the condition of the patient is usually bad. The person will suffer from congestion of the lungs and will be very short of breath, sweaty, with low blood pressure and may go into congestive heart failure or cardiogenic shock . When examined by a physician, an evident murmur will be heard over the chest and bubbling sound can be heard over the patient lungs. Chest x-rays nearly always show signs of pulmonary congestion, pulmonary edema, and pulmonary venous engorgement. Diagnosis of this condition is usually confirmed with echocardiography. Treatment: Papillary muscle rupture is a surgical emergency that requires emergency mitral valve replacement. However the patient condition should be stabilized until the time of surgery. The patient is usually given big doses of diuretics, oxygen therapy and in severe case a breathing tube may be inserted and the patient is connected to a mechanical respirator. An intra-aortic balloon pump may help stabilize the patient’s condition while being prepared for mitral valve replacement surgery. The procedure is very high risk, but there is no available treatment except this emergency mitral valve replacement . In few cases some surgeons may attempt mitral valve repair. Unfortunately, because this condition is a complication of a heart attack , some other operations can be done in the same setting. This can include coronary artery bypass grafts and, in some cases, repair of a left ventricular aneurysm. The chance of surviving emergency mitral valve replacement for papillary muscle rupture is about 70 percent, and most of the survivors do well providing the left ventricle has not been too badly damaged by the heart attack. 
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