Mitral Valve Regurgitation Caused by Infarcted Papillary Muscles: A Report of Fifteen Cases.

Orlando, Michael D.

doi:10.7326/0003-4819-61-4-801_1

Cited by 4 publications

(3 citation statements)

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“…Unlike some authors (Orlando et al, 1964;Robinson et al, 1965;Morrow et al, 1968;Heikkila, 1971;Sanders et al, 1971), but in agreement with Heikkila (1967), we did not find a higher incidence of mitral regurgitation in patients with posteroinferior myocardial infarction than in those with anterior infarction. This distribution corresponded well with the frequency of valvar regurgitation in various patterns of coronary arterial disease.…”

Section: Discussionsupporting

confidence: 91%

“…It has been thought to be the result of (a) dysfunction of papillary muscles from acute ischaemia or irreversible fibrosis or necrosis Phillips et al, 1963;Orlando et al, 1964;Heikkila, 1967Heikkila, , 1971De Pasquale and Burch, 1971); (b) rupture of papillary muscleleaflet connection (Cederqvist and Soderstrom,1964;Robinson, et al 1965;Morrow et al, 1968); (c) ventricular wall dyskinesis (Burch et al, 1971 Shelburne andGorlin, 1972), and aneurysm with abnormal spatial relations of the papillary muscles; (d) dilatation of the mitral valve ring in ventricular dilatation (Holloway et al, 1965;Friedberg, 1966); or (e) asynchronous contraction, e.g. in arrhythmias (Vandenberg et al, 1969), may lead to valvar regurgitation.…”

Section: Discussionmentioning

confidence: 99%

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Mitral regurgitation in coronary heart disease.

Gahl¹,

Sutton²,

Pearson³

et al. 1977

Heart

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Mitral regurgitation is a relatively common finding in coronary heart disease. In this series of 127 patients, selected with a view to coronary or left ventricular surgery on the basis of severity of symptoms, the incidence was 39 (31%). Mitral regurgitation is significantly more common in patients with a history or electrocardiographic evidence ofprevious myocardial infarction. Clinically it may present as a pan-or late systolic or even a mid-systolic, ejection type murmur at the apex or at the left sternal edge; but in 39 per cent of the patients with angiographic mitral regurgitation no murmur was present. Angiographically important mitral regurgitation (grades 2-4/4) was usually associated with a systolic murmur; this finding was independent of ejection fractions. Left ventricular enlargement clinically or radiographically is likely to accompany mitral regurgitation but left atrial enlargement (electrocardiographically or on chest x-ray) is a more reliable pointer to mitral regurgitation and pulmonary venous hypertension is even more strongly suggestive of its presence. The electrocardiographic signs of papillary muscle infarction were rare in this series (15%) and were not related to angiographic mitral regurgitation. There was no difference in the incidence of mitral regurgitation in association with anterior or inferior myocardial infarction or in distribution of coronary artery disease. There is, however, a higher incidence of mitral regurgitation in more severe coronary arterial disease (P<005).The incidence of mitral regurgitation is significantly higher with reduction in left ventricular ejection fraction (P< 0001), with rise in the left ventricular end-diastolic pressure (P<0'02), and with abnormalcontraction patterns, but the severity of mitral regurgitation is not significantly related to these findings.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Mitral regurgitation in coronary heart disease.

Gahl¹,

Sutton²,

Pearson³

et al. 1977

Heart

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show abstract

“…In some small series of patients with this complication the occurrence of mitral incompetence without papillary muscle rupture has been ascribed to "papillary muscle dysfunction" caused by infarc--tion or ischemia Phillips, Burch, and De Pasquale, 1963;Orlando et al, 1964;Bashour, 1965). The murmur arising from this kind of mitral incompetence has been described by some of these investigators as pansystolic (Orlando et al, 1964;Bashour, 1965), and by others as ejection in type Phillips et al, 1963;Segal and Likoff, 1964). In a few cases the presence of mitral incompetence has been confirmed by angiocardiographic studies (Mazzitello, 1964;Holloway, Whalen, and McIntosh, 1965;Tavel, Campbell, and Zimmer, 1965).…”

mentioning

confidence: 99%