Mitral Insufficiency Secondary to Ruptured Chordae Tendineae

Article1 August 1966Mitral Insufficiency Secondary to Ruptured Chordae TendineaeRICHARD H. CHILDRESS, M.D., JOSEPH C. MAROON, M.D., PASQUALE D. GENOVESE, M.D., F.A.C.P.RICHARD H. CHILDRESS, M.D., JOSEPH C. MAROON, M.D., PASQUALE D. GENOVESE, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-65-2-232 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMitral insuffiency due to rupture of the chordae tendineae is a relatively rare entity and, until recently, one primarily of academic interest. Heretofore the diagnosis was rarely considered and was usually made at postmortem examination. Since surgical repair of mitral insufficiency is now possible, an increased interest in this disorder has developed.Five male patients with this disorder have been studied at this hospital during the past 6 years. The clinical features demonstrate a wide spectrum of physical and hemodynamic findings.Several factors have been implicated in the etiology of ruptured chordae tendineae. The first report by Corvisart (1) in...References1. CORVISART JN: An Essay on the Organic Diseases and Lesions of the Heart and Great Vessels. A. Finley, Boston, 1812, Hafner Publishing Co., New York, 1962, p. 178. Google Scholar2. HEPPERBURCHELLEDWARDS NGHBJE: Mitral insufficiency in healed unrecognized bacterial endocarditis. Mayo Clin. Proc. 31: 649, 1956. Google Scholar3. OSMUNDSONCALLAHANEDWARDS PJJAJE: Ruptured mitral chordae tendineae. Circulation 23: 42, 1961. CrossrefMedlineGoogle Scholar4. MENGESANKENEYHELLERSTEIN HJLHK: The clinical diagnosis and surgical management of ruptured mitral chordae tendineae. Circulation 30: 8, 1964. CrossrefMedlineGoogle Scholar5. ROBERTSBRAUNWALDMORROW WCEAG: Acute severe mitral regurgitation secondary to ruptured chordae tendineae: clinical, hemodynamic, and pathologic considerations. Circulation 33: 58, 1966. CrossrefMedlineGoogle Scholar6. BAILEYHICKAM OTJB: Rupture of mitral chordae: clinical and pathologic observations on seven cases in which there was no bacterial endocarditis. Amer. Heart J. 28: 578, 1944. CrossrefGoogle Scholar7. MORRISPENNERBRANDT JDDARL: Surgical correction of ruptured chordae tendineae. J. Thorac. Cardiov. Surg. 48: 772, 1964. CrossrefMedlineGoogle Scholar8. SANDERSSCANNELLHARTHORNEAUSTEN CAJGJWWG: Severe mitral regurgitation secondary to ruptured chordae tendineae. Circulation 31: 506, 1965. CrossrefMedlineGoogle Scholar9. MCLAUGHLINCOWLEYSMITHMATHESON JSRAGNA: Mitral valve disease from blunt trauma. J. Thorac. Cardiov. Surg. 48: 261, 1964. CrossrefMedlineGoogle Scholar10. FROTHINGHAMHASS CGM: Rupture of normal chordae tendineae of mitral valve. Amer. Heart J. 9: 492, 1934. CrossrefGoogle Scholar11. SHAPIROWEISS HADR: Mitral insufficiency due to ruptured chordae tendineae simulating aortic stenosis. New Eng. J. Med. 261: 272, 1959. CrossrefMedlineGoogle Scholar12. JANUARYFISHEREHRENHAFT LEJMJL: Mitral insufficiency resulting from rupture of normal chordae tendineae. Report of surgically corrected case. Circulation 26: 1329, 1962. CrossrefMedlineGoogle Scholar13. SELZERVANNITAMBYKELLYKERTHGERBODE AMJJWJFL: Syndrome of mitral insufficiency due to rupture of chordae tendineae (abstract). Circulation 32: 192, 1965. Google Scholar14. OSMUNDSONCALLAHANEDWARDS PJJAJE: Mitral insufficiency from ruptured chordae tendineae simulating aortic stenosis. Mayo Clin. Proc. 33: 235, 1958. MedlineGoogle Scholar15. HUMPHRIESMCKUSICK JOVA: The differentiation of organic and "innocent" systolic murmurs. Progr. Cardiov. Dis. 5: 152, 1962. CrossrefMedlineGoogle Scholar16. MATTINGLY TW: Clinical features and diagnosis of primary myocardial disease. Mod. Conc. Cardiov. Dis. 30: 677, 1961. MedlineGoogle Scholar17. MENGESBRANDENBURGBROWN HROAL: The clinical, hemodynamic, and pathologic diagnosis of muscular subvalvular aortic stenosis. Circulation 24: 1126, 1961. CrossrefMedlineGoogle Scholar18. TEARE D: Asymmetrical hypertrophy of the heart in young adults. Brit. Heart J. 20: 1, 1958. CrossrefMedlineGoogle Scholar19. EDWARDSBURCHELL JEHB: Endocardial and intimal lesions (jet impact) as possible sites of origin of murmurs. Circulation 18: 946, 1958. CrossrefMedlineGoogle Scholar20. STAMPBACHSENN OA: Idiopathic hypertrophic subaortic stenosis. Schweiz. Med. Wschr. 92: 125, 1962. MedlineGoogle Scholar21. FREW HW: Rupture of chordae tendineae following scarlet fever. Glasgow Med. J. 115: 195, 1931. MedlineGoogle Scholar22. BARBER H: The effects of trauma, direct and indirect, on the heart. Quart. J. Med. 13: 137, 1944. Google Scholar23. WOOD P: Diseases of the Heart and Circulation, 2nd ed. J. B. Lippincott Co., Philadelphia, 1956, p. 932. Google Scholar24. HORTON-SMITH P: A clinical lecture on mitral regurgitation. Clin. J. 19: 252, 1902. Google Scholar25. WIGLE ED: In Cardiomyopathies (Ciba Foundation Symposium), edited by WOLSTENHOLME, G. E. W., O'CONNOR, J. Little Brown & Co., Boston, 1964, p. 294. Google Scholar26. BURCHELL HB: Possibly unrecognized forms of heart disease. Circulation 28: 1153, 1963. CrossrefMedlineGoogle Scholar27. PHILLIPSBURCHDEPASQUALE JHGENP: The syndrome of papillary muscle dysfunction. Its clinical recognition. Ann. Intern. Med. 59: 508, 1963. LinkGoogle Scholar28. LEPESCHKIN E: Genesis of the U wave. Circulation 15: 77, 1957. CrossrefMedlineGoogle Scholar29. FURBETTABUFALARISANTUCCI DAF: La Parte Terminale del Ventricologramma—onda U e Tratto TU-e la Sindrome dei Musculi Papillari. Società Editrice "Universo," Rome, 1955. Google Scholar30. FURBETTABUFALARISANTUCCISOLINAS DAFP: Abnormality of the U wave and TU segment of the electrocardiogram. The syndrome of the papillary muscles. Circulation 14: 1129, 1956. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: RICHARD H. CHILDRESS, M.D.; JOSEPH C. MAROON, M.D.; PASQUALE D. GENOVESE, M.D., F.A.C.P.Affiliations: Indianapolis, IndianaFrom the Medical Service, Veterans Administration Hospital, Indianapolis, Ind., and the Department of Medicine, Indiana University School of Medicine, Indianapolis, Ind.This study was supported in part by grant HE 06308, U. S. Public Health Service, Bethesda, Md., and the Indiana Heart Association, Indianapolis, Ind.Dr. Maroon was an Indiana Heart Association Cardiovascular Research Fellow when this work was performed.Requests for reprints should be addressed to Pasquale D. Genovese, M.D., Medical Service, Veterans Administration Hospital, 1481 W. 10th St., Indianapolis, Ind. 46222. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byLong-term outcomes of patients with flail mitral valve leafletsEarly Surgery in Patients With Mitral Regurgitation Due to Flail LeafletsAcute severe mitral regurgitation. Pathophysiology, clinical recognition, and managementLaceration of a mitral papillary muscle and the aortic root as a result of blunt trauma to the chestCardiogenic shock and pulmonary edemaChordal rupture. I: aetiology and natural history.Endocardite bactérienne et insuffisance mitrale avec rupture de cordagesErworbene HerzklappenfehlerHemodynamics in Ruptured Chordae Tendineae and Chronic Rheumatic Mitral RegurgitationAcquired, nonrheumatic mitral regurgitation: Clinical management with emphasis on evaluation of myocardial performanceCardiac Pathology in the HorseRepair of Mitral Incompetence Secondary to Ruptured Chordae TendineaeNonrheumatic Mitral InsufficiencyThe Murmurs of Mitral RegurgitationThe syndrome of mitral insufficiency due to isolated rupture of the chordae tendineaeSignificance of an Atrial Gallop Sound in Mitral Regurgitation 1 August 1966Volume 65, Issue 2Page: 232-244KeywordsEndocarditisEtiologyHeartHemodynamicsHospital medicineLongitudinal studiesMedical servicesMitral insufficiencyStenosisSurgical repair ePublished: 1 December 2008 Issue Published: 1 August 1966 PDF downloadLoading ...