Key result
Isolated distal RCA occlusion can trigger acute anterolateral papillary muscle rupture via dominant perfusion.
Why the study?
Ischemic rupture of the anterolateral papillary muscle is uncommon due to its dual blood supply and typically follows ischemia in left coronary branches, but rupture from isolated right coronary artery lesions is not well documented.
Case Report (n=1)
May warrant evaluation for distal RCA occlusion in anterolateral papillary muscle rupture; leaves open mechanistic confirmation in larger cohorts.
Ischemic rupture of the anterolateral papillary muscle is uncommon due to its dual blood supply. It usually follows an ischemic event involving branches of the left circumflex or left anterior descending arteries. We present a case of a patient admitted with an acute inferior wall myocardial infarction and an isolated distal right coronary artery occlusion. Acute mitral regurgitation with rupture of the anterolateral papillary muscle was diagnosed on the fifth post-infarction day. The patient underwent mitral valve replacement and coronary artery bypass grafting to the posterior descending artery. We conclude that anterolateral papillary muscle rupture may also result from an isolated right coronary lesion.
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Stefanovski et al. (2012) conducted a case report in Acute inferior wall myocardial infarction with anterolateral papillary muscle rupture (n=1). Isolated distal right coronary artery occlusion was evaluated on Anterolateral papillary muscle rupture. An isolated distal right coronary artery occlusion can lead to acute anterolateral papillary muscle rupture, likely due to right predominance of blood supply or an embolic event.
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