PMC3671306_01
Cardiac echography, apical four chambers view. Echodense prolapsing 10 mm mass attached to the anterior mitral valve leaflet leading to severe mitral regurgitation.
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Two days later, the patient developed cardiogenic shock, and a repeat transthoracic echocardiogram revealed a new echodense prolapsing mass of 10 mm attached to the anterior mitral valve leaflet, as well as severe mitral regurgitation (Figure 1).
Autopsy image of the mitral valve showing the upper portion of the ruptured papillary muscle (arrow).
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In the midportion of the anterolateral papillary muscle, this necrosis was most evident and had resulted in rupture (Figure 2).