Anomalous Papillary Muscle Producing Dynamic Left Ventricular Outflow Tract Obstruction

Roldan, Carlos A.; Gurule, Frank T.; Shively, Bruce K.

doi:10.1016/s0894-7317(14)80026-6

Cited by 7 publications

(2 citation statements)

References 8 publications

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“…Klues et al (3) described this anomaly in association with HCM, though it may also occur in otherwise normal hearts or in patients with other types of heart disease. In case reports that have been described by a small number of authors, this anomaly was found in a total of 15 cases: in conjunction with HCM in six patients (9)(10)(11)(12)(13) and without evidence of HCM in nine patients (6,(14)(15)(16)(17)(18)(19)(20). In all of the 23 patients from the case series, the anomaly has been associated with HCM.…”

Section: Discussionmentioning

confidence: 94%

Anomalous Anterior Papillary Muscle as an Autopsy Finding in Two Cases

Strajina

Živković

Nikolić

2013

Journal of Forensic Sciences

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Anomaly in the anterior papillary muscle (APM) is known to cause left ventricle outflow tract (LVOT) obstruction, and this rare congenital condition could be a cause of sudden cardiac death. This anomaly and its hemodynamic effects is similar to valvular heart disease. In our two described cases, in which cause of death was, respectively, hypertrophic cardiomyopathy and suicide by hanging, the cephalad portion of the left APM was inserted directly into the ventricular surface of the anterior mitral leaflet and chordae tendineae were absent in the area of the direct anomalous muscle insertion; the aberrant papillary muscle was very large and showed an exaggerated anterior displacement within the left ventricular cavity. The described anomaly is a cause of LVOT obstruction. This condition is considered to be rare, although incidence estimates do not exist. In the absence of other possible causes, this finding may indicate arrhythmia as being the immediate cause of death.

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Section: Discussionmentioning

confidence: 94%

Anomalous Anterior Papillary Muscle as an Autopsy Finding in Two Cases

Strajina

Živković

Nikolić

2013

Journal of Forensic Sciences

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show abstract

“…In addition, a few case reports have described the clinical presentation and management of APMI in the HCM population [3–8]. In subjects who do not meet classic criteria for HCM, isolated APMI has been described in only four case reports to date, each describing papillary muscle attachment to either the basal or ventricular surface of the mitral valve leaflets [6, 9–11]. In two other case reports of non-HCM subjects, this aberrancy was shown to be present alongside discrete subaortic stenosis [12, 13].…”

Section: Case Discussion/conclusionmentioning

confidence: 99%