An Incomplete Anterolateral Papillary Muscle Rupture in Patient with Suspected Septic Shock

Papillary muscle rupture (PMR) is a cardiac surgical emergency, and early treatment is associated with better short- and long-term survival outcomes. The sensitivity of the transthoracic echocardiogram for PMR is rather low (65%), and in acute, the diagnosis could be difficult given the clinical, laboratory, and radiological aspects not specific for the disease. We report a case of incomplete anterolateral PMR in a patient admitted to intensive care with bilateral pneumonia and septic shock. Transesophageal echocardiogram was fundamental for a better visualization of mitral subvalvular apparatus, allowing a correct diagnosis and a tempestive treatment.