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In acute MR secondary to a mechanical defect in the heart (i.e., rupture of a papillary muscle or chordae tendineae), the treatment of choice is mitral valve surgery. If the patient is hypotensive prior to the surgical procedure, an intra-aortic balloon pump may be placed in order to improve perfusion of the organs and to decrease the degree of MR.
The role of these macrophages is the removal of necrotic myocytes. However, these cells are directly involved in the weakening of the tissue, leading to complications such as a ventricular free wall rupture, intraventricular septum rupture, or a papillary muscle rupture. At a gross anatomical level, this staged is marked by a yellow pallor.
Rupture of a papillary muscle will cause acute mitral regurgitation. [citation needed] The rupture will most often occur near the edge of the necrotic myocardium where it abuts healthy (but hyperemic) myocardium where the inflammatory response is at its greatest. Further, the rupture will occur in an area of greatest shear stress. Within the ...
Papillary muscle rupture can be caused by a myocardial infarction, and dysfunction can be caused by ischemia. Rarely, blunt chest trauma can be the cause of papillary muscle rupture, resulting from the sudden deceleration or compression of the heart. [4] Complications may lead to worsening of mitral regurgitation. [5]
Parachute mitral valve occurs when all the chordae tendineae of the mitral valve attach to a single papillary muscle. [9] [10] [11] This causes mitral valve stenosis at an early age. [10] It is a rare congenital heart defect. [11] Although it often causes mitral insufficiency, it may not present any symptoms. [10]
Causes include mitral valve prolapse, tricuspid valve prolapse and papillary muscle dysfunction. Holosystolic (pansystolic) murmurs start at S1 and extend up to S2. They are usually due to regurgitation in cases such as mitral regurgitation, tricuspid regurgitation, or ventricular septal defect (VSD). [4]
Whereas, disease of the valve is categorized to primary mitral regurgitation or secondary mitral regurgitation based on the regurgitant etiology. Type II pertains to excessive leaflet motion leading to leaflet prolapse. Common causes include, but is not limited to, Barlow disease, myxomatous degeneration, inflammation, and papillary muscle rupture.
In the United States, MVP is the most common cause of severe, non-ischemic mitral regurgitation. [4] This is occasionally due to rupture of the chordae tendineae that support the mitral valve. [11] The severity of regurgitation in MVP is typically estimated using a grading system: [16] [17] [18] 0 (none or trivial) Grade 1 (mild) Grade 2 (moderate)