PMC9164910_01
(a) Transthoracic echocardiogram (TTE), four chamber-view. Arrow points to large mobile mass in the left ventricle (LV) attached to the mitral apparatus. (b) Modified TTE four chamber view. Arrow points to the mass attached the anterolateral papillary muscle. (c) TTE parasternal long axis (PSLA) view. Measurements of the mass (arrow). (d) TTE color Doppler mode. The absence of color on the mass. (e and f) Transesophageal echocardiogram (TTE) views. Arrow points to the same mass in the left ventricle attached to the mitral apparatus. Ao: Aorta, LA: left atrium
JCE-32-60-g001.jpg
PMC9164910_01_JCE-32-60-g001.jpg
F1
An echocardiographic evaluation revealed a normal global systolic left ventricular function, no valvular disease but we noted a 15 mm x 11 mm mobile oscillating large mass with an echogenic content attached to the mitral anterolateral papillary muscle [Figure 1].
(a) Transthoracic echocardiogram (TTE), parasternal long axis (PSLA) view. Arrow points to image prolapsed to the left atrium (LA) during. (b) Modified PSLA view showed important mitral regurgitation due to the anterior mitral valve prolapse. (c-e) Transesophageal echocardiogram (TEE). Arrow points to mobile mass in the left ventricle (LV) with important mitral regurgitation. (f) Transgastric TEE view. Arrow points to anterolateral papillary muscle rupture. Ao: Aorta
JCE-32-60-g002.jpg
PMC9164910_01_JCE-32-60-g002.jpg
F2
Echocardiographic studies showed a hyperdynamic left ventricle with no regional wall motion abnormality but we noticed severe mitral regurgitation with a prolapse of the anterior mitral valve due to the rupture of the mitral anterolateral papillary muscle, which explained the patient clinical status [Figure 2].
Arrow points to the rupture of the tip of the anterolateral papillary muscle on surgical inspection
JCE-32-60-g003.jpg
PMC9164910_01_JCE-32-60-g003.jpg
F3
On surgical inspection, complete rupture of the anterolateral papillary mitral muscle was found [Figure 3].