Papillary muscles of left ventricle—Morphological variations and it’s clinical relevance

Abstract

Graphical abstractComparison of present and previous study reports regarding muscles origin from ventricular walls.

Glossopharyngeal insufflation and kissing papillary muscles

“…Applying Equation (1) gave a diameter of 4.6 cm. If a papillary muscle diameter of about 1.0 cm is accepted, 23 then the papillaries are unlikely to touch each other.…”

Differential diagnosis of apical hypertrophic cardiomyopathy and apical displacement of the papillary muscles: a multimodality imaging point of view

“…The attachment site could be purely apical or mixed with an accessory PM extending to the mid‐ventricular segments. The insertion site differences may include left ventricular outflow tract (LVOT), and basal or mid‐portions of the mitral valve with or without chordae tendineae 6,17‐19 . Anomalous insertion of PM is a common finding in HCM patients having a prevalence of 10%.…”

“…An "ace-of-spades" sign is considered to be the pathognomonic configuration for ApHCM ( Figure 2); nevertheless, thickened or abnormally positioned PMs may have the same finding. 15,16 PMs usually originate from mid-ventricular segments; however, [17][18][19] there are various types of ADPM with regard to the number of PM heads, anatomy, attachment, and insertion sites that should be demonstrated for differential diagnosis. The attachment site could be purely apical or mixed with an accessory PM extending to the mid-ventricular segments.…”

“…The insertion site differences may include left ventricular outflow tract (LVOT), and basal or mid-portions of the mitral valve with or without chordae tendineae. 6,[17][18][19] Anomalous insertion of PM is a common finding in HCM patients having a prevalence of 10%. In addition, the prevalence of ADPM (especially anterolateral papillary muscle) is higher in patients with HCM, which can complicate the differential diagnosis.…”

Electrocardiographic characteristics of idiopathic ventricular arrhythmias based on anatomy

“…For example, there exists an apparent variability in the relationship among the components of the tricuspid valve (Tretter, Sarwark, Anderson, & Spicer, 2016). And the papillary muscles vary markedly in their numbers, shapes, and patterns in both ventricles (Saha & Roy, 2018;Xanthos, Dalivigkas, & Ekmektzoglou, 2011). Such congenital variations exist in the conduction system as well, which may partially account for the rhythm abnormalities after transcatheter surgery (Saadi et al, 2018).…”