The Rupture of the head of postmedial papillary muscle. Mechanical complications of myocardial infraction with normal angiographic image of coronary vessels.
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Szpital Wojewódzki Nr 2 w Rzeszowie
Łukasz Kądziela   

Szpital Wojewódzki Nr 2 w Rzeszowie, Lwowska 60, 96a, 35-301 Rzeszów, Poland
Publication date: 2017-03-21
Heart Beat 2016;1:76–79
Background Myocardial infarction with non-obstructive coronary arteries (MINOCA) is usually mild in course without any life-threatening complications. The following paper presents the atipical case of a 74-year-old patient with myocardial infraction who despite normal angiography image suffered from complete tear of the head of papillary muscle followed by acute cardiac failure and cardiogenic shock. Conclusions The prognosis of myocardial infraction with no significant changes in coronary arteries is usually good and any life-threatening complications are unlikely to appear. However, myocardial necrosis may cause mechanical damages to myocardium even when the coronary vessels are unobstructed. Cardiac infraction pathomechanism in the case described above is not entirely clear. The most probable cause due to atrial fibrillation history is an embolism which lysed spontaneously.