Spontaneous papillary muscle rupture in the absence of coronary artery disease

Papillary muscle rupture is an unusual pathology, commonly being a mechanic al complication of an acute myocardial infarction or a blunt chest trauma. In this case report we describe a patient with a spontaneous complete poste romedial papillary muscle rupture, secondary to an isolated papillary muscl e infarction, in the absence of coronary artery disease, resulting in sever e mitral regurgitation, cardiogenic shock and uneventful urgent mitral valv e replacement. The clinical and histopathologic literature, and mechanisms to explain this kind of rupture, are reviewed.