A 33-year-old male patient was admitted to the coronary care unit with an inflammatory syndrome and elevated troponin T. Shortly after admission the patient developed cardiogenic shock due to an anterior papillary muscle rupture and died after an urgent surgical replacement of the mitral valve. Histological examination of the excised papillary muscle showed signs of an acute myocarditis but no myocardial ischaemia. This case represents the first description of a papillary muscle rupture, a potentially lethal complication, due to acute myocarditis.
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