Papillary muscle Rupture

Rupture of a papillary muscle is usually associated with an infarction of which area of myocardium?

• (A) Inferior
• (B) Inferior–posterior
• (C) Lateral
• (D) Anterior
• (E) Anteroseptal

The answer is B.

Papillary muscle rupture is usually associated with an inferior–posterior infarction and involves the posterior papillary muscle. Outcome depends on whether the entire muscle body or only the head is ruptured. Rupture of an entire muscle body is associated with a high mortality rate (up to 50 percent within 24 h).

Diagnosis of papillary muscle dysfunction or rupture may be made on echocardiography or by measuring large V waves in the pulmonary artery wedge pressure with a Swan-Ganz catheter.

Papillary Muscle Infarct with Rupture: Gross, an excellent example of ruptured papillary muscle.