Key result
Emergency physician-performed echocardiography rapidly diagnosed papillary muscle rupture in a 59-year-old male presenting with undifferentiated shock, facilitating prompt surgical management.
Why the study?
Papillary muscle rupture is a catastrophic complication of acute myocardial infarction where survival depends on rapid diagnosis and transfer for surgery.
Case Report (n=1)
Point-of-care echocardiography by emergency physicians can rapidly diagnose rare and catastrophic complications like papillary muscle rupture in patients presenting with undifferentiated shock.
Bedside echo by skilled emergency physicians enables rapid post-MI papillary muscle rupture diagnosis; leaves open impact on time-to-surgery and survival.
INTRODUCTION: Rupture of a papillary muscle is an extremely rare but catastrophic complication of an acute myocardial infarction. Survival is time dependent on the expedition of the patient from the area of presentation to the operating theatre for surgery. Diagnosis in the ED is possible within minutes of presentation if an echo is performed by an emergency physician skilled in echocardiography, as we demonstrate. CASE PRESENTATION: We present a case of a 59 years male self-presenting to the emergency department with undifferentiated shock. An EP performed echo directed us towards the rare but correct diagnosis. He was then transferred for percutaneous coronary intervention and surgical management. CONCLUSION: Often in the past a diagnosis made on coronary care units or post-mortem, we believe this diagnosis in the future will be made more frequently at the bedside in emergency departments across the world as emergency physicians continue to incorporate echocardiography as a skill in their diagnostic armoury.
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Mukherjee et al. (2019) conducted a case report in Papillary muscle rupture presenting as undifferentiated shock (n=1). Emergency physician-performed echocardiography was evaluated on Diagnosis of papillary muscle rupture. Emergency physician-performed echocardiography rapidly diagnosed papillary muscle rupture in a 59-year-old male presenting with undifferentiated shock, facilitating prompt surgical management.
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