Why does the murmur of papillary muscle dysfunction come and go? A new explanation for an old phenomenon.

摘要

In 1963 Burch et al. introduced the concept and syndrome of papillary muscle dysfunction. They described two patients who developed an apical systolic murmur of delayed onset suggestive of mitral insufficiency following an acute myocardial infarction and at necropsy found infarction without rupture of papillary muscles in both. Subsequently the same investigators collected 11 additional cases and described the clinical and electrocardiographic characteristics of the syndrome of papillary muscle dysfunction. The characterization of mitral insufficiency due to papillary muscle dysfunction without rupture was further amplified by this author in 1969 and 1972 . Around about the same time, Roberts and Perloff and Perloff and Roberts published their elegant reports on the mitral valve apparatus, further enhancing our understanding of the function and dysfunction of the papillary muscles.