Mitral Regurgitation Following Myocardial Infarction: The Syndrome of Papillary Mitral Regurgitation

¹ Cardiopulmonary Laboratory, Department of Internal Medicine, University of Texas Southwestern Medical School

The clinical picture of papillary mitral regurgitation was described and two illustrative patients were reported. The diagnosis was clinically made by the appearance of a pansystolic apical murmur following the onset of myocardial infarction. In three patients, a left ventricular aneurysm was observed.

The condition is believed to result from either damage to the papillary muscle or its displacement by the aneurysmal sac or by both.

The disease is compatible with long survival. Congestive heart failure is the major complication. Two patients developed bacterial endocarditis. Total mitral valve replacement is indicated, whether or not ventricular aneurysm is present, in patients with severe form of the disease.